Primary tubercolous osteomyelitis of the sternum

We present an 82-year-old woman with anterior sternal pain diagnosed as primary mycobacterial osteomyelitis of the sternum. She was treated with simultaneous wide resection and reconstruction of the chest wall. On admission, computed tomographic scan showed a sclerotic sternal mass with soft tissue reaction. Mycobacterium tuberculosis was grown in initial culture. First-line antituberculous medication and local debridement failed. The successful result was achieved by extensive sternal and chondral resection followed by simultaneous bilateral pectoralis major muscle flap positioning.