Multiple bone tuberculosis in a child from predynastic Upper Egypt (3200 BC)

Abstract

Tuberculosis, one of the most ancient human diseases, was present in ancient Egypt and has been observed since predynastic times. Excavations in the predynastic to early dynastic necropolis of Adaima, Upper Egypt (3500-2700 BC) led to the discovery of a number of remarkably well-preserved skeletons of children. The skeletal remains of a 4.5-5-year-old child dated from Nagada III A2 (3200-3100 BC) displayed various lesions on the post-cranial skeleton: spondylitis on the thoracic (T12) and lumbar (L1) vertebrae, partial lytic destruction of the right radio-ulnar joint, lytic lesions on the scapula and a clavicle, dactylitis on the short bones of hands and feet, enlargement (spina ventosa) and periosteal new bone formation on the long bones. Radiographs show well-defined radiolucent (cyst-like) lesions in the metaphysis and the diaphysis of long tubular bones (ulna, radius, femur, tibia, fibula). The lesions recorded during macroscopic and radiological analysis strongly suggest a case of multiple bone tuberculosis. The occurrence of this case of tuberculosis in a child provides a picture of a period where tuberculosis must have been endemic throughout the population living during the origins of urban settlement in Upper Egypt during the predynastic period.

A 6500-year-old Middle Neolithic child from Pollera Cave (Liguria, Italy) with probable multifocal osteoarticular tuberculosis

“…This new Neolithic evidence of multifocal, disseminated skeletal TB, with its multiplicity of bony lesions, might be useful for understanding disease progression in the past, and possibly helping scholars in the diagnosis of other skeletons where the evidence is more limited/nonspecific, and remains are incomplete (Wilbur et al, 2009;Roberts et al, 2009) In the bioarchaeological literature, multifocal TB has been reported in a 4-5-year-old child from Predynastic Upper Egypt (AD S 500; 3,200 BC; Dabernat and Crubézy, 2010).…”

“…Buikstra, 1981;Klaus et al, 2010;Roberts, 2015). In the Neolithic Old World, skeletons with the infection have been reported in the Near East and North Africa (Ortner, 1979(Ortner, , 1999Strouhal, 1987;El-Najjar et al, 1997;Crubézy et al, 1998;Zias, 1998;Dabernat and Crubézy, 2010), with the potential Israeli evidence dating back to the eighth millennium BC (Hershkovitz et al, 2008). Skeletal TB has also been reported from Neolithic continental Europe (Bartels, 1907;Sager et al, 1972;Dastugue and de Lumley, 1976;Bennike, 1999;Gladykowska-Rzeczycka, 1999;Nuorala et al, 2004;Masson et al, 2013Masson et al, , 2015Köhler et al, 2014;Posa et al, 2015).…”

“…However, lesions attributed to TB have been described in children from the Roman period in Britain (Lewis, 2011) and Hungary (Hlavenkova et al, 2015), showing that the lesions of TB can be recognized in the archaeological record of children. The most convincing skeletal evidence is described in a 4-5-year-old individual with Pott's disease from Predynastic Upper Egypt (3,200 BC; Dabernat and Crubézy, 2010). The lesions described in a 12-month-old individual from Israel (9,000 BP, Hershkovitz et al, 2008Hershkovitz et al, , 2015 have also been attributed to TB based on the molecular detection of the pathogen.…”

Diagnosis of Mercurial Teeth in a Possible Case of Congenital Syphilis and Tuberculosis in a 19th Century Child Skeleton

“…In children, common areas affected by the disease included the knee [72,73], lytic circumscribed lesions of the cranium [7,74,75], spine [71,76], hip [73,77], elbow [78], and ribs [76]. There is no documentation with regard to dental abnormalities found in juvenile tuberculosis [7,79]. Dental changes briefly mentioned include linear enamel hypoplasia [80,81], carious lesions, and decreased enamel thickness [80].…”

Evidence of tuberculosis among children in medieval (13th–15th century) Wrocław: A case study of hip joint tuberculosis in a juvenile skeleton excavated from the crypt of the St. Elizabeth church

“…Dabernat and Crubézy 2010;Lewis 2011;Matos et al 2011;Dawson and Brown 2012, Ioannou et al 2015, Hlavenková et al 2015, Sparacello et al 2017). The reason is that the tuberculosis of bones and joints in children can take on a variety of less evident forms, which complicates the macroscopic evaluation.…”