Tuberculosis of the skull vault: a case report

Area of Science:

• Pediatric infectious diseases
• Skeletal tuberculosis
• Radiology and imaging

Background:

• Tuberculous osteitis is a rare manifestation of tuberculosis, particularly in children.
• Osteitis can affect cranial and facial bones, presenting with varied clinical signs.
• Early recognition is crucial for timely intervention and management.

Observation:

• A 3-year-old boy presented with fluctuating head swellings and an infra-orbital sinus.
• Clinical presentation suggested an infectious or inflammatory process.
• Radiological findings indicated multifocal, circumscribed, and lytic bone lesions.

Findings:

• The patient's symptoms and radiological findings were consistent with tuberculous osteitis.
• Tuberculous osteitis can manifest as multifocal, lytic bone lesions on imaging.
• Bone biopsy is essential for confirming the diagnosis of tuberculous osteitis.

Implications:

• This case highlights the importance of considering tuberculous osteitis in pediatric patients with unexplained cranial or facial swellings.
• Accurate diagnosis through bone biopsy is critical for appropriate treatment of skeletal tuberculosis.
• Radiological features, while suggestive, require histological confirmation for definitive diagnosis.