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Isolated Sternal Tuberculosis Presenting as a Chest Wall Abscess: A Case Report
Priyanka Anand1, Namrata Sarin1
1Department of Pathology; North Delhi Municipal Corporation Medical College and Hindu Rao hospital, Delhi, India.
Iranian Journal of Medical Sciences
|July 27, 2018
Summary
Primary sternal tuberculosis is a rare condition, presenting as a chest wall abscess in this case. Early diagnosis is crucial for effective treatment of this uncommon form of extrapulmonary tuberculosis.
Area of Science:
- Medical Microbiology
- Orthopedic Surgery
- Radiology
Background:
- Tuberculosis (TB) is a significant global health issue, with pulmonary TB being most common in India.
- Extrapulmonary TB, including bone and joint involvement (1-3% of cases), is less frequent.
- Primary tuberculous osteomyelitis of the sternum is an exceptionally rare manifestation.
Observation:
- A 51-year-old male presented with a decade-long anterior chest wall swelling and recent pain.
- Fine-needle aspiration cytology (FNAC) showed necrotic debris and positive Ziehl-Neelsen staining for acid-fast bacilli.
- Contrast-enhanced CT revealed sternal erosion, despite a normal chest X-ray.
Findings:
- The case highlights primary tuberculous osteomyelitis of the sternum.
- Diagnostic confirmation involved FNAC, Ziehl-Neelsen staining, and CT imaging.
- Sternal tuberculosis represents a rare form of flat bone tuberculosis.
Implications:
- Sternal tuberculosis should be considered in patients with sternal masses, non-healing ulcers, or abscesses.
- This case underscores the importance of considering rare diagnoses in persistent or unusual presentations.
- Awareness of sternal TB can lead to earlier diagnosis and improved patient outcomes.
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