{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T03:35:44Z","timestamp":1764732944402,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:00:00Z","timestamp":1631145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Tuberculosis is considered one of the great masqueraders alongside syphilis and vasculitis. Pott disease is recognized as a classic manifestation of tuberculosis, yet it stands as a rare infectious syndrome in regions with low tuberculosis disease burden. To illustrate the challenges of diagnosing Pott disease in these settings, we report two cases and offer a brief overview of management recommendations for vertebral osteomyelitis caused by Mycobacterium tuberculosis. Case one concerns an 81-year-old man with a remote history of incarceration who presented with altered mental status and new pleural effusions. Case two is a 49-year-old man with well-controlled HIV who was transferred to our institution after being found to have extensive destruction of L3\u2013L5 vertebrae and bilateral iliopsoas abscesses on outpatient imaging. These stand as illustrative examples of low and high suspicion for tuberculosis, respectively, and both cases required complex diagnostic and management decisions.<\/jats:p>","DOI":"10.3390\/pathogens10091158","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T21:36:58Z","timestamp":1631223418000},"page":"1158","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pott Disease: A Tale of Two Cases"],"prefix":"10.3390","volume":"10","author":[{"given":"Christopher","family":"Radcliffe","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Grant","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1016\/S0140-6736(19)30308-3","article-title":"Tuberculosis","volume":"393","author":"Furin","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Houben, R.M., and Dodd, P.J. (2016). The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1002152"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1016\/j.socscimed.2009.03.041","article-title":"Drivers of tuberculosis epidemics: The role of risk factors and social determinants","volume":"68","author":"Lonnroth","year":"2009","journal-title":"Soc. Sci. Med."},{"key":"ref_4","first-page":"54","article-title":"Percivall Pott","volume":"50","author":"Dobson","year":"1972","journal-title":"Ann. R Coll. Surg. Engl."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1093\/cid\/civ326","article-title":"Characteristics and Clinical Outcome of Bone and Joint Tuberculosis From 1994 to 2011: A Retrospective Register-based Study in Denmark","volume":"61","author":"Johansen","year":"2015","journal-title":"Clin. 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Neurosurg Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100151","DOI":"10.1016\/j.jctube.2020.100151","article-title":"Challenges and controversies in the treatment of spinal tuberculosis","volume":"19","author":"Pandita","year":"2020","journal-title":"J. Clin. Tuberc. Other Mycobact. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1093\/cid\/ciw376","article-title":"Official American Thoracic Society\/Centers for Disease Control and Prevention\/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis","volume":"63","author":"Nahid","year":"2016","journal-title":"Clin. Infect Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1164\/rccm.201909-1874ST","article-title":"Treatment of Drug-Resistant Tuberculosis. An Official ATS\/CDC\/ERS\/IDSA Clinical Practice Guideline","volume":"200","author":"Nahid","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_12","unstructured":"Collaborative Group for the Meta-Analysis of Individual Patient Data in MDR-TB treatment-2017, Ahmad, N., Ahuja, S.D., Akkerman, O.W., Alffenaar, J.C., Anderson, L.F., Baghaei, P., Bang, D., Barry, P.M., and Bastos, M.L. (2018). Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: An individual patient data meta-analysis. Lancet, 392, 821\u2013834."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"507","DOI":"10.3171\/2016.9.SPINE16174","article-title":"The epidemiology of spinal tuberculosis in the United States: An analysis of 2002-2011 data","volume":"26","author":"Goodwin","year":"2017","journal-title":"J. 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Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.jbspin.2012.10.001","article-title":"Changes in the incidence and management of spinal tuberculosis in a French university hospital rheumatology department from 1966 to 2010","volume":"80","author":"Wibaux","year":"2013","journal-title":"Joint Bone Spine"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/9\/1158\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:59:15Z","timestamp":1760165955000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/9\/1158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,9]]},"references-count":15,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["pathogens10091158"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10091158","relation":{},"ISSN":["2076-0817"],"issn-type":[{"type":"electronic","value":"2076-0817"}],"subject":[],"published":{"date-parts":[[2021,9,9]]}}}