Tuberculosis of the spine in children: risk factors, clinical picture and diagnostics (clinical observation)

Tuberculosis of the musculoskeletal system in children is currently a rare pathology. Low incidence contributes to insufficient alertness on the part of both pediatricians and surgeons and orthopedic traumatologists. In this regard, ostitis and spondylitis of tuberculous etiology, even in the presence of a phthisiatric anamnesis (active tuberculosis of the respiratory organs, a history of tuberculosis, changes in tuberculin tests, social and medical risk factors, etc.) are diagnosed already at the stage of bone tissue destruction. With late diagnosis and without timely assistance for spinal tuberculosis in children and adolescents, in 100 % of cases, disability occurs, the degree of which increases with age. The purpose of this demonstration is to attract the attention of specialists in various fields to the problem of the development of severe complications of tuberculosis in children with untimely diagnosis of the disease and the absence of etiotropic therapy. Clinical observation: child B., 5 years old, from an asocial family. During the examination, a diagnosis of tuberculosis of the intrathoracic lymph nodes in the consolidation phase was established. The child's mother refused inpatient treatment. A year later, tuberculous spondylitis C5-Th1, complicated by abscess, was diagnosed. The development of the disease was facilitated by low alertness of general practitioners in terms of the development of extrapulmonary tuberculosis in a child with several risk factors for the disease, the passive position of the child's parents, their refusal of etiotropic therapy in inpatient settings, and the absence of stable, regulated relationships between employees of medical organizations and social services.

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