Tuberculous Osteomyelitis Presenting as a Sternal Mass in Paediatric Patient: A Case Report
C. Nasmi *
Department of Pediatrics, Military Hospital Mohamed V of Rabat, Morocco.
A. Radi
Department of Pediatrics, Military Hospital Mohamed V of Rabat, Morocco.
R. Abilkassem
Department of Pediatrics, Military Hospital Mohamed V of Rabat, Morocco.
A. Agadr
Department of Pediatrics, Military Hospital Mohamed V of Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Sternal tuberculosis is an uncommon form of extrapulmonary tuberculosis and it can be a diagnostic challenge for pediatricians.
Case Presentation: We report the case of a young 14-year-old boy, who had a gradually increasing swelling of the sternum over the past 2 months preceded by weight loss, asthenia and night sweats. Radiological, histological, and microbiological investigations confirmed it as a case of sternal tuberculosis (TB). He was managed with surgical debridement during the sternal biopsy and quadruple antituberculosis therapy with good response.
Discussion: Tuberculosis (TB) of sternum is one of the rarest forms of skeletal tuberculosis. The incidence of sternal tuberculosis has been calculated to be <1.5% amongst osteo-articular tuberculosis, with very few cases reported in infants. The diagnosis is based on histological and bacteriologic arguments.
Conclusion: Tuberculous osteomyelitis of the sternum is a rare finding in children. Our aim is to increase awareness around atypical presentations and the uncommon involvement of the sternum in musculoskeletal tuberculosis.
Keywords: Tuberculosis, musculoskelatal, sternum, swelling, osteomyelitis, infants
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References
Vijay V, Vaishya R. Isolated C-C joint tuberculosis—a diagnostic dilemma. Foot (Edinb). 2015;25:182–6.
Bouytse K, Benamor J, Bourkadi J. Facteurs de risque et diagnostic de la tuberculose au Maroc. Rev des Mal Respir Actual. 2021;13(1):227.
Aziz Ouarssani, Fouad Atoini, Fatima Ait Lhou, Mustapha Idrissi Rguibi. La tuberculose sternale: A propos de 2 cas. Pan African Medical Journal; 2012.
Shah MM, Gupta G, Modi P, Baldev S, Prajapati. Infantile sternal tuberculosis: A rare condition. Indian Pediatr Case Rep. 2021;1:170-2.
Bains L, Lal P, Chand T, Gautam KK, Beg MY, Kumar P. Isolated primary cold abscess of the sternum: A case report. J Med Case Rep. 2019;13:267.
Kutty S, Bennett D, Devitt A, Dowling FE. Tuberculous osteomyelitis of the sternum in an infant: A case report and review of the literature. Focus on Tuberculosis Research. 2005;181.
Smith I. Mycobacterium tuberculosis pathogenesis and molecular determinants of virulence. Clin Microbiol Rev. 2003;16: 463-96.
Calabro E, Pastorino U. Primary sternal tuberculosis mimicking a lytic bone tumor lesion. Monaldi Arch Chest Dis. 2018;88: 931.
Joshi P, Bavdekar SB, Save SU. A swelling over sternum in a child: Reminder of an uncommon diagnosis. Case Rep Pediatr. 2016;2016:3765786.
Atasoy C, Oztekin PS, Ozdemir N, et al. CT and MRI in tuberculous sternal osteomyelitis: A case report. Clin Imaging. 2002;26:112-5.
Wen H, Li P, Ma H, Lv G. Diagnostic accuracy of Xpert MTB/RIF assay for musculoskeletal tuberculosis: A meta-analysis. Infect Drug Resist. 2017;10:299-305.
Asif A, Dabral L. Sternal Tuberculosis: Case Series of Two Cases. Journal of Orthopaedic Case Reports. 2021 November;11(11): 59-63.
Rajan, Bizanti. Sternal swelling presenting as tuberculosis: A case report, Journal of Medical Case Reports. 2021;15:580.