Primary Calvarial Tuberculosis: a report of three cases

Abstract

Calvarial tuberculosis is rare presentation and has been reported in only about 0.01% of all patients with mycobacterial infections. Though rare, the incidence of Calvarial tuberculosis seems to be on the rise, especially in developing countries. We present three cases of Calvarial tuberculosis which were successfully managed at our Centre. All the cases occurred de novo in young, otherwise healthy individuals, hailing from good socio-economic backgrounds and without any past history or contact history with tuberculosis patients. We highlight the importance of keeping this diagnosis in mind in appropriate clinical situations as well as recommend the early commencement of optimal management to prevent serious neurologic complications & sequelae.

Calvarial Tuberculosis: A Diagnostic Quandary: A Case Report

“…CT scans reveal extradural compression, if present, and help to rule out associated intradural lesions as tuberculomas or subdural empyemas. 1,7 Chest radiographs are generally of little help-it was normal in our case. Contrast-Enhanced CT (CECT) is useful in diagnosis of Calvarial tuberculosis.…”

“…It demonstrates the soft tissue swelling, the bony destruction and the extra-dural collection if any. 1 Magnetic Resonance (MR) imaging, in most cases, leads to a conclusive diagnosis. Proton density and T2-weighted images show a high signal-intensity soft-tissue mass within the defect in bone.…”

“…17 It is usually not possible to reach a conclusive diagnosis on the basis of imaging alone. 1 Microbiologic or histologic confirmation is essential. Demonstration of Acid-fast bacilli in the pus smear by Ziehl-Neelsen stain and presence of caseous granuloma on histopathologic examination provides conclusive evidence of tuberculosis infection.…”

“…Calvarial Tuberculosis is a rare entity and has been reported in only 0.01% of all patients with mycobacterial infections. 1 Calvarial TB in middle aged male with no evidence of tuberculosis elsewhere in body is very rare. 2 It is interesting to note that, this case occurred in young, healthy man without any past history of tuberculosis.…”

An Isolated Skull Lesion in Syphilis

“…Solitary plasmacytoma is very rare and usually presents a painless, soft swelling . The major symptoms in primary calvarial tuberculosis are pain, scalp swelling, and discharging sinus, but there can be only scalp swelling without pain . Bone pain and deformity can occur in Paget's disease, but incidental findings of an elevated serum alkaline phosphatase or an abnormal radiograph is a typical presentation .…”