Tuberculosis presenting as an anterior chest wall swelling: three cases

Area of Science:

• Pediatric Infectious Diseases
• Medical Imaging
• Histopathology

Background:

• Tuberculosis (TB) is a prevalent infectious disease in India.
• Paediatric TB constitutes 6-7% of all TB cases.
• Skeletal and soft tissue TB are uncommon presentations.

Purpose of the Study:

• To investigate paediatric anterior chest wall swelling as a rare manifestation of tuberculosis.
• To highlight the importance of considering intrathoracic tuberculosis in differential diagnosis.
• To report on the diagnostic and therapeutic outcomes in affected children.

Main Methods:

• Retrospective case series of three children (1-11 years) presenting with anterior chest wall swelling.
• Clinical evaluation, imaging studies (including chest X-ray and CT scans), and histopathological examination.
• Initiation of anti-tuberculosis therapy and clinical follow-up.

Main Results:

• All three patients presented with anterior chest wall swelling and underlying bony and pulmonary/pleural involvement.
• Histopathology confirmed tuberculosis in all cases.
• Children showed significant clinical improvement after commencing anti-TB therapy.

Conclusions:

• Anterior chest wall swelling in children, especially in TB-endemic areas, should raise suspicion for tuberculosis with intrathoracic extension.
• Prompt diagnosis via imaging and histopathology, followed by anti-TB treatment, leads to favorable outcomes.
• Tuberculosis should be a close differential diagnosis for such presentations, even in the absence of known TB contact.