[Sacral bone tuberculosis in a 6 year-old child].
BACKGROUND
Spinal tuberculosis is now rare in developed countries; its appearance in sacral vertebrae is exceptional.


METHODS
A 6 year-old boy was admitted because he had suffered from lumbar pain and rigidity for 24 hours, limiting anterior flexion. X-rays of the spine was normal, but a CT-scan showed lytic lesions of the sacrum. Bone scintigraphy showed no inflammatory lesions. Ewing sarcoma was diagnosed: surgical biopsy showed a cold abscess containing many bacilli that where resistant to decoloration with acid-alcohol. They were cultured for 12 days and identified as Mycobacterium tuberculosis. The boy had been given a BCG vaccination at the age of 2 years and was not immunodeficient. He was treated with isoniazid, rifampin and pyrazinamide for 2 months followed by isoniazid plus rifampin for 1 year. A cold abscess in the presacral area rupturing into the sacro-iliac articulation pointed above the left iliac wing during treatment and was treated by surgical debridement. Eighteen months later, the boy is well but still avoids bending.


CONCLUSIONS
A sacrally located bone tuberculosis is difficult to diagnose. Careful therapy is necessary to avoid sequelae that may lead to spinal curvature.
Service de pédiatrie, hôpital Jean-Bernard, Poitiers, France.
F
F
Raymond
G
G
Levard
B
B
Bataille
D002648:Child; D006801:Humans; D008297:Male; D012447:Sacrum; D015898:Tomography Scanners, X-Ray Computed; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000628:therapy
Tuberculose osseuse sacrée chez un enfant de 6 ans.