Background Tuberculosis continues to be a worldwide public health problem. Despite the noted gradual decline in tuberculosis case rates in the UK, clinicians should still be aware of these unusual presentations. Sternal tuberculosis is an uncommon form of extrapulmonary tuberculosis and it can initially be a diagnostic challenge for paediatricians. These lesions can present with nonspecific signs and symptoms that may mimic malignancy. Case presentation We present a case of a 3-year-old African descent girl with a sternal swelling that was confirmed to be Mycobacterium tuberculosis complex DNA on gastric aspirate. The child had additional radiological investigations that corresponded accordingly. She was started on quadruple antituberculosis therapy with good outcome. Conclusion Tuberculosis sternal abscess is as rare finding, especially in developed countries where tuberculosis is not endemic. Tuberculosis may not always present with pulmonary symptoms in children. There should be a high suspicion of tuberculosis, especially in immigrant population presenting with unusual presentations. Our aim is to increase awareness around atypical presentations of tuberculosis in children. Although, tuberculosis is endemic to underdeveloped countries, clinicians should still be aware of presentations in view of current global migration.

The development of personalized medicine (PM) has shifted medicine from "one size fits all" principle to tailoring treatment to patients' characteristics to get the intended benefits in a faster time with the least possible harm. In the early days whenever a patient is diagnosed with a certain disease, a known first-line medicine will be prescribed. If this first line fails, then we would follow the algorithm and use the next one. In the last century with the wide use of researches and massive volume of publications, the concept of evidence-based medicine has made a huge change in modern medicine. It is expected that the new millennium will be the PM era. PM in its simplest understanding is providing a tailored medication according to the patient's need. After using appropriate tool to identify the patient's genetic characteristics, a specific treatment with minimal side effects and higher rate of response would be prescribed. The first uses of this concept emerge from adult practice and the use of a specific treatment for patients with specific enzyme defects in cystic fibrosis, as we will discuss in details below. Oncology is the area that currently uses PM more than any other medical speciality. The aim of this article was to describe what the PM is about and what could be its expected benefits. We have reviewed the literature and obtained the most relevant articles. We will then mention some examples of applying PM in current pediatrics.