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Tuberculous suprasternal notch abscess in a child
1Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, India.
Insights
Tuberculosis, a global emergency, can present unusually. This case highlights a rare suprasternal notch abscess in a child, successfully treated with antituberculous therapy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) is a significant global health challenge, necessitating awareness of its diverse clinical manifestations.
- Uncommon presentations of TB can delay diagnosis and treatment, impacting patient outcomes.
- Cervical lymphadenitis is a frequent cause of neck masses in children.
Observation:
- A rare case of an anterior midline swelling in a child is presented.
- The swelling was identified as a tuberculous suprasternal notch abscess, a rare complication secondary to lymphadenitis.
- Radiological imaging showed necrotic tissue at the suprasternal notch base.
Findings:
- Needle aspiration and cytology confirmed tuberculous lymphadenitis as the cause of the neck swelling.
- Antituberculous therapy was initiated for the child.
- The treatment resulted in complete healing of the associated ulcer and resolution of the abscess.
Implications:
- This case underscores the importance of considering tuberculosis in the differential diagnosis of midline neck swellings in children.
- Early diagnosis and appropriate antituberculous treatment are crucial for favorable outcomes in rare TB presentations.
- Raising awareness of such rare sites can improve the early identification and management of pediatric tuberculosis.
Abstract:
Tuberculosis has been declared a 'Global Emergency' by the WHO. Owing to the magnitude of the problem, knowledge of unusual presentations at rare sites can help identify the disease early and achieve good to fair results. We present one such rare case of a child with an anterior midline swelling. An anterior midline swelling in a child raises multiple diagnostic possibilities. Although cervical lymphadenitis is a common cause of neck swelling, tuberculous suprasternal notch abscess, secondary to lymphadenitis, has rarely been described. Radiological investigations revealed necrotic tissue in the base of the suprasternal notch. The diagnosis was made using needle aspiration and cytology, which was suggestive of tuberculous lymphadenitis for the neck swelling. Antituberculous therapy gave good results, with complete healing of the ulcer and resolution of the abscess.
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