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An elderly male with tubercular osteomyelitis of the chest wall
Parvaiz A Koul1, M Ashraf, Rafi A Jan
1Department of Internal Medicine and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India. parvaizk@gmail.com
Abstract:
Primary tuberculosis of the ribs is rare. A 70-year-old male presented with a 6-month history of a chest wall swelling that ruptured over few weeks to lead to a chronic discharging sinus. He had been administered multiple antibiotics, but the discharge continued. Clinical examination revealed anaemia, cervical lymphadenopathy and a 2-cm splenomegaly. Investigations revealed a normochromic and normocytic anaemia (Hb 7.0 g/dl), an ESR of 60 and a positive tuberculin sensitivity test of 25 mm. Surgical excision of the sinus along with the underlying revealed a caseous rib with histopathological features of a caseating granuloma. The patient was put on antitubercular therapy and is doing well on follow-up.
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