We report a case of tuberculous spondylitis (Pott's disease) with bilateral pleural effusion in a 25-year-old male patient, Left-pleural effusion was observed on admission. The initial diagnosis was tuberculous pleuritis. However, during anti-tuberculosis chemotherapy, back pain and right-pleural effusion appeared, by further examination, we diagnosed an active tuberculous spondylitis of the 11th and 12th thoracic vertebrae possibly by the dissemination of Mycobacterium tuberculosis through blood circulation or lymphatic circulation. In cases in which anti-tuberculosis chemotherapy is not so effective, the possibility of the rarely-appearing extra-pulmonary manifestation of tuberculous spondylitis must be considered.
(Internal Medicine 35: 883-885, 1996)