Extensive calvarial tuberculosis: rare complication of tuberculous mastoiditis

Abstract

Tuberculous mastoiditis is a well-documented entity with decreasing incidence in recent years. Tuberculous osteitis of the skull is even rarer. The case of a 58-year-old male with tuberculous mastoiditis complicated by extensive tuberculous osteitis of the skull is presented. This case serves to demonstrate both the difficulty in establishing the diagnosis of tuberculosis and the potentially disastrous consequences of the disease.

Calvarial tuberculosis: Uncommon manifestation of common disease – a series of 21 cases

“…A ring of fibroblasts may surround this giving an appearance of a well-circumscribed punched out lesion. 6 In cases of compromised immunity, the spread could occur via the diploe ultimately perforating the inner and outer tables and presenting as epidural granulation or a scalp swelling, respectively. The presentation is highly varied.…”

“…There may be a surrounding zone of increased density; however, extensive sclerosis is uncommon. 5,6 Computer tomography can be better used to delineate these bony pathologies. MRIbrain may required, however, to rule out intra-cranial pathology.…”

Relationship between tuberculous otomastoiditis and tuberculous meningitis

“…The isolation of M tuberculosis , particularly in specimens taken pre- or intra-operatively, confirms the diagnosis of tuberculous otomastoiditis. In addition, since isolation of the tuberculous bacillus is not always possible, analysis of clinical, radiological and histopathological findings and response to anti-tuberculous treatment are of great importance in establishing an early and accurate diagnosis 11 , 12 , 14 , 15 . In our study, individuals' previous clinical findings, radiological findings and response to anti-tuberculous treatment were adopted as diagnostic criteria.…”