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Related Experiment Videos

Mycobacterium tuberculosis presenting as sternal osteomyelitis.

K J Stewart1, O A Ahmed, R B Laing

  • 1Department of Plastic and Reconstructive Surgery, Aberdeen Royal Infirmary, U.K.

Journal of the Royal College of Surgeons of Edinburgh
|May 24, 2000
PubMed
Summary

Tuberculosis can cause sternal osteomyelitis, presenting as a presternal abscess. Diagnosis may be delayed, as Mycobacterium tuberculosis cultures can be negative initially, even after multiple surgical procedures.

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Area of Science:

  • Infectious Diseases
  • Surgical Oncology
  • Osteomyelitis Research

Background:

  • Sternal osteomyelitis is a rare but serious infection often requiring surgical intervention.
  • Tuberculosis (TB) is an important differential diagnosis for osteomyelitis, particularly in endemic areas or in immunocompromised patients.
  • Presternal abscess and axillary lymphadenopathy can be presenting signs of underlying sternal infection.

Observation:

  • A 54-year-old female presented with a presternal abscess and subsequent axillary lymphadenopathy.
  • Imaging studies confirmed sternal osteomyelitis.
  • Initial microbiological cultures were negative for Mycobacterium tuberculosis.

Findings:

  • The patient's sternal osteomyelitis was successfully treated with surgical resection and muscle flap reconstruction.

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  • Mycobacterium tuberculosis was ultimately identified via culture after the fourth surgical procedure.
  • This case highlights the challenges in diagnosing tuberculous osteomyelitis.

    • Implications:

    • Negative initial microbiology results should not preclude consideration of Mycobacterium tuberculosis in suspected cases of osteomyelitis.
    • Early and accurate diagnosis of tuberculous osteomyelitis is crucial for effective treatment and patient outcomes.
    • Surgeons and infectious disease specialists must maintain a high index of suspicion for TB in complex osteomyelitis cases.