what problem is this???

[pawanj]

my son nikhil jindal aged 20 years had neck pain and stiffness abt a month back followed by fever (100 to 101.6) after 3-4 days of neck pain started.
on 26 mar he was put on topcef 200mg 2 tabs a day for 3 days all medicines were given to patient
on 27 mar his blood was tested and report was as under
TLC 12,600,
DLC- NEUTROPHILS 69.2, LYMPHOCYTES 21.3, MONOCYTES 7.8, EOSINOPHILS 1.1, BASOPHILS 0.6
ESR(WESTREGEN'S) 102
S.G.P.T.(A.L.T.) 31.23
WIDAL TEST WAS NEGATIVE
BASED ON ABOVE TESTS DOCTOR SUGGESTED FOR CHEST X RAY
0n 29 mar he was put on topcef 200mg tab mobizox for another 3 days all medicine wr given to patient
x ray report of chest  was normal
but still fever (99 to 101) and pain continues
doctor suggested x ray cervical spine on 29 mar
report was as under
straightening of spine is seen with loss of normal curvature suggestive of muscle spasm
irregularity of articular surface of c5 seen
prevertebral soft tissue thickening is seen
cystic lesion seen anteriorly at body of c6
disc spaces are normal
no cervical rib is seen
ADVISED - MRI CERVICAL SPINE
DOCTOR REFERRED THE PATIENT TO ORTHOPEDIC BASED ON ABOVE REPORT
ortho doc put on the following treatment
inj monocef 1gm I.V - BD
inj Acenac MR  1 BD
these injections were injected for 5 days
doctor suggested for MRI cervical spine
report dated 05 apr his test report was as under
there is straightening of cervical spine
cervicodorsal vertebral bodies from c2 to d4 level reveal focal or diffuse marrow signal intensity alterations hypointense on T1W1 and hyperintense on STIR images, suggestive of marrow edema/inflation. marrow edema is most marked in c6 vertabral bodies.
large prevertabral abscess is seen in cirvicodosral region displaying hypo to isointense signals on T2W1. abscess is predominantly seen on the left side of midline involving preverbtal muscles with mild extensions on right side in right preverbtal muscles.
cranially it is extending upto c2 verteba and caudally till d4 in posterior aspect of superior mediastium. abscess is also seen to extending into left c5-6 and c6-7 neural foramina with mild posterolateral wall of oropharynx and upper esophagus.
CSF shows normal signal intensity. cord shows normal morphology and signal.
CV junction is normal.
IMPRESSION - MR imaging features aree suggeastive of infective spondylitis with large pre vertebal abscess from c2 to d4 and mild epidural extension at c6 level.
Etiology - likely tubercular
his blood test report dated 06 apr was as under
TLC 10,600
DLC- NEUTROPHILS 68.4, LYMPHOCYTES 22.1, MONOCYTES 7.6, EOSINOPHILS 1.4, BASOPHILS 0.5
ESR(WESTREGEN'S) 110
S.G.P.T.(A.L.T.) 48.57
TSH- 2.020
BASED ON ABOVE INVESTIGATIONS and his continue temp (99 to 100) and neck pain
doctor put him on
AKT 4 1 kit in morning
oflaxin 1 OD 400 mg
tab liv 52 2tabs BD
a second opinion was taken and it was suggested that patient is suffering from pott spine( cervical spine)
and he put on
AKT 4 daily for 1 month
tab pyridoxine 10 mg daily for 1 month
philadiflion collar(MGRM)
also complete bed rest was advised
the patient started taking AKT4 and pyridoxine from 06 apr as par above suggestion

another opinion was taken and it was suggested
to start phase I
rest in bed for 22 hrs for 1 and half month
tab Rcinex 300+600 mg daily in morning
tab oflox 400 mg daily in morning

shelcal-1
cobadex-1
ciplection 1
all above for 5 monthes
somi brace to be worn by pateint

and another opinion said
Tab R-Cinex 300 mg + 600 mg – 1 OD – 2 months (before breakfast)
Tan Ethambutol – 800mg – 1OD – 2 months (Afternoon )
Tab. Pyraziharide 750mg –1-0-1 - 2 months
Tab. Pyridoxine 20mg – 1OD – 2 months
Tab. Hifenac 100mg – 7-10 days – 1-0-1
Repeat ESR, LFT

kindly suggest if it is 100% sure that my son is infected with pott spine
or any other test is reqd to be done for confirmation
can this be some other disease and not pott spine
i want to give treatment after only 100% confirmation of the disease and not in doubt pls
how can it be confirmed
4 doctors have suggested different types of treatment although all  diagnosed same disease and other one suggested for DOTS
sir, i m in total confusion
kindly advice which medicine is the best in india for pott spine
an advice from an expert doctor like u will be a real help to humankind

may i also request u to kindly atleast suggest me which option i opt for the treatment of TB
right now he is on option 2, do he really need complete bed rest and for how long, what precautions he need to take, what sud he eat and wat not, any other care/advice pls
option 1
AKT 4 1 kit in morning
oflaxin 1 OD 400 mg
tab liv 52 2tabs BD

option 2
AKT 4 daily for 1 month
tab pyridoxine 10 mg daily for 1 month
philadiflion collar(MGRM)
also complete bed rest was advised

option 3
rest in bed for 22 hrs for 1 and half month
tab Rcinex 300+600 mg daily in morning
tab oflox 400 mg daily in morning

shelcal-1
cobadex-1
ciplection 1
all above for 5 monthes
somi brace to be worn by pateint

option 4
DOTS

option 5

Tab R-Cinex 300 mg + 600 mg – 1 OD – 2 months (before breakfast)
Tan Ethambutol – 800mg – 1OD – 2 months (Afternoon )
Tab. Pyraziharide 750mg –1-0-1 - 2 months
Tab. Pyridoxine 20mg – 1OD – 2 months
Tab. Hifenac 100mg – 7-10 days – 1-0-1
Repeat ESR, LFT

[pawanj]

thanx a lot for your concern

[Tuckamore]

Hello Pawanj,

Welcome to the Pain Management Forum. I an so sorry to hear about your sons disease. I am sure that all these opinions must be confusing to you....they certainly are to me. You have provided a lot of facts, thank you.

Pott's disease, is a presentation of extrapulmonary tuberculosis that affects the spine, a kind of tuberculous arthritis of the intervertebral joints.

Our community does not contain any physicians. I cannot even guess as to what treatment may be best for your son. Please know that you are always welcome here. We care about your son but are not knowledgeable enough to recommend or suggest any treatments. With all due respect I am going to request that your post (questions) be moved to another forum. Our moderators have better knowledge of all our communities can can direct this to one that can provide you with better answers.

My heart goes out to you and your son and I wish you the very best.

Take Care,
~Tuck