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Related Experiment Videos

Primary sternal tuberculosis treated by resection and reconstruction

W Hajjar1, A M Logan, P R Belcher

  • 1Department of Plastic Surgery, West Norwich Hospital, Norwich, United Kingdom.

The Thoracic and Cardiovascular Surgeon
|December 1, 1996
PubMed
Summary

A rare case of primary sternal infection caused by mycobacteria was observed in an 81-year-old man. Surgical excision and histology confirmed the infection, highlighting the importance of considering mycobacterial causes in persistent chest wall infections.

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Area of Science:

  • Infectious Diseases
  • Surgical Pathology
  • Medical Imaging

Background:

  • Primary mycobacterial sternal infections are uncommon, presenting diagnostic challenges.
  • Persistent parasternal sinus infections may indicate deeper pathology beyond initial assessment.
  • Antibiotic therapy alone often provides only palliative relief for such complex infections.

Observation:

  • An 81-year-old male presented with a four-month history of a parasternal sinus infection with palliative response to antibiotics.
  • Computed tomography (CT) revealed chest wall thickening but no initial bone involvement.
  • Intraoperative findings indicated infection extending to the manubrium and anterior portions of the first three ribs.

Findings:

  • Histopathological examination of the excised tissue revealed caseating granulomata, characteristic of mycobacterial infection.

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  • No other tuberculous foci were identified in the patient, suggesting a localized primary sternal infection.
  • The surgical intervention involved excision of the manubrium and anterior segments of the first three ribs.

    • Implications:

    • This case underscores the necessity of considering mycobacterial etiology in recalcitrant sternal and chest wall infections.
    • Early and accurate diagnosis through advanced imaging and surgical exploration is crucial for effective treatment.
    • Aggressive surgical management combined with appropriate antimicrobial therapy may be required for successful outcomes in primary sternal mycobacterial infections.