Calvarial Tuberculosis: A Diagnostic Quandary: A Case Report

Abstract

Primary Calvarial Tuberculosis, a rare entity of skull is even rarer after second decade of life in a healthy person without evidence of tuberculosis elsewhere in the body. Most of the cases are often misdiagnosed as osteomyelitis/syphilis/bony metastasis.
 We report a case of primary skull tuberculosis in 26-year-old male with complains of headache and swelling in the right frontal region with no history of previous tuberculosis. The patient was operated and the histopathological examination of excised tissue was suggestive of tubercular pathology. The patient is doing well after anti-tubercular therapy.
 Being a rare disease, tubercular osteomyelitis of skull bones is often missed and misdiagnosed due to lack of clinical suspicion and slow growth of mycobacterium cultures. Histopathological examination of biopsy material and demonstration of acid-fast bacilli in the pus are helpful for diagnosis and early management of the disease.

Case Report: Cranial Tuberculosis in a Patient without Tuberculosis Foci Elsewhere in the Body

“…The increased number of blood vessels and reduced resistance caused by trauma may cause M. tuberculosis to colonize the site of trauma, resulting in lesions. 2 Therefore, a high degree of suspicion for primary cranial TB is required when a patient with a history of craniocerebral trauma or surgery presents with osteolytic lesions with cephalic masses.…”

“…1 Patients with primary cranial tuberculosis are easily overlooked because they have no previous history of tuberculosis and no tuberculosis foci in other parts of the body; they are often misdiagnosed as having neoplastic lesions, osteomyelitis, or cranial syphilis. 2 Herein, we report the first case of primary cranial tuberculosis in our hospital.…”

Osteomielitis tuberculosa del cráneo, a propósito de un caso

“…En el caso de este paciente, se demostró la baciloscopia positiva de la muestra de secreción tomada. Otra prueba usada ante la sospecha de CTB es la prueba de Mantoux, pero esta puede ser negativa en el 10% de los casos; la velocidad de eritrosedimentacion (VSG), PCR o ELISA también contribuyen al diagnóstico, pero resultan inespecíficas (11,12). Se utilizan también pruebas de imagen, aunque en una radiografía simple en estadios iniciales no hay alteración, y cuando la infección ha progresado, se puede evidenciar una lesión lítica excéntrica, un defecto cortical u osteopenia local.…”

A Case of Calvarial Tuberculosis in an Elderly Male Patient

“…3 Calvarial Tuberculosis involving the skull bones is a rare extra-pulmonary manifestation of TB. 4 Approximately 1% of all patients with Tuberculosis 1 have bone involvement and of these only 0.2% -1.3% are diagnosed as having TB of calvarium. 2 A possible reason for this low incidence might be scarcity of lymphatics in the skull bone.…”