Tuberculosis of Sternum

Rajput, AK; Rajan, K N; Rk, Gupta; Mp, Muttagikar

doi:10.1016/s0377-1237(01)80017-4

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…Plain radiographs are often normal but radiographic techniques like computed tomography (CT) and MRI are more valuable for localization and detection of bone destruction and soft tissue abnormalities. The common features on CT of sternoclavicular TB include bone and cartilage destruction, soft tissue masses crossing fascial planes with rim (abscess) and diffuse enhancement (granulation tissue), calcifications, and underlying pleuroparenchymal tubercular involvement [17–19]. MRI delineates abscesses better in the soft tissues, and highlights bone marrow involvement [5, 17–19].…”

Section: Discussionmentioning

confidence: 99%

“…The common features on CT of sternoclavicular TB include bone and cartilage destruction, soft tissue masses crossing fascial planes with rim (abscess) and diffuse enhancement (granulation tissue), calcifications, and underlying pleuroparenchymal tubercular involvement [17–19]. MRI delineates abscesses better in the soft tissues, and highlights bone marrow involvement [5, 17–19]. Atasoy et al demonstrated the role of MRI for early detection of marrow and soft tissue involvement in sternal TB due to the high contrast resolution of MRI [20].…”

Section: Discussionmentioning

confidence: 99%

“…Late changes are osteomyelitis, joint effusions, and bone destruction. Sinus tract formation, which appears as linear high signal intensity (SI) on T2-weighted images with marginal “tram-track enhancement”, may also be seen [17]. Ultrasound is of limited value in early stages but picks up abscesses, osteolytic sternal lesions, or rib lesions later [17].…”

Section: Discussionmentioning

confidence: 99%

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Isolated primary cold abscess of the sternum: a case report

et al. 2019

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Background Musculoskeletal tuberculosis forms 10–25% of extrapulmonary tuberculosis which mainly involves the spine or weight-bearing joints. Tuberculous involvement of the sternum is a rare clinical entity even in countries where tuberculosis has high prevalence. Primary tuberculous sternal osteomyelitis accounts for approximately 0.3% of all types of tubercular osteomyelitis and the probable source appears to be extension from paratracheal or hilar lymph nodes. Despite tuberculosis being a common disease in endemic countries and worldwide, a thorough literature search of the PubMed database for keywords “primary tuberculosis of sternum” and “primary tuberculous osteomyelitis of sternum” yielded 30 and 22 articles, respectively. Case presentation We present an unusual case of a large dumb-bell-shaped cold abscess arising due to infection of the sternum. A 23-year-old immunocompetent Asian woman presented with a gradually progressing painless swelling on anterior chest wall for the last 5 months. She had a large visible swelling on anterior chest wall which was 12.5 cm in diameter, soft, non-tender, temperature was not raised, and fluctuant. Magnetic resonance imaging showed a large dumb-bell-shaped hyperintense collection in upper anterior chest wall with marrow edema and cortical irregularity in left side of manubrium. Pus was positive for nucleic acid testing (cartridge-based nucleic acid amplification test) for Mycobacterium tuberculosis and later culture was also positive. She was started on anti-tubercular therapy and aspirated twice. Currently, she has completed 6 months of therapy and the swelling has now disappeared. Discussion Swelling, pain localized to sternum, or ulceration of the skin with discharging sinus along with or without constitutional symptoms are the usual presentation. A high element of suspicion is needed for early diagnosis and treatment to prevent its complications. Sternal mycobacterial infections are categorized as primary, secondary, and/or acquired postoperatively. Although radiological investigations aid in diagnosis, the diagnosis is established by positive culture or histopathological examination. Anti-tubercular therapy is the mainstay of treatment with standard four-drug regimen for 6–9 months. Surgical drainage of the abscess should be considered only if it does not resolve by aspiration and anti-tubercular therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Isolated primary cold abscess of the sternum: a case report

et al. 2019

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“…Third, our patient presented with involvement of the sternal bone which is also very rare. 12 Skeletal TB represents 10% of extra pulmonary tuberculosis. 1 Among patients with skeletal TB, spinal and rib involvement accounts for approximately 50% and 5% of the cases, respectively.…”

Section: Discussionmentioning

confidence: 99%

A rare presentation of multifocal tuberculosis in an immunocompetent patient

Mansour¹

2023

JLPRR

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Introduction: Multifocal tuberculosis (MT) is an uncommon presentation in immunocompetent patients. It’s associated more with an immune-depression like Human Immunodeficiency Virus infection. We report a case of MT with presternal cold abscess, mediastina and cervical adenopathy, bone, and vertebral location that occurred in an apparently immunocompetent patient. Case presentation: A 19-year old woman with no previous history of tuberculosis (TB) exposure was admitted for chronic chest pain lasting for 13 months. She presented with a history of fever, night sweat and weight loss (09 kg). The first clinical examination noticed a voluminous presternal abscess. The chest X-Ray showed an enlargement of the middle mediastinum associated to pleural effusion opacity, but any active pulmonary lesions. A computed chest tomography revealed the presence of a parietal mass centered on the sternum, with extension in the soft parts, bone lies of the sternal manubrium, lies of the vertebral hemi-bodies of T10 and T11, cervical lymph nodes, phrenic mediastina and sub-pectoral nodes with peritoneal and mesenteric involvement. Magnetic resonance imaging of the spine showed tiered thoracic lumbar and sacral spondylitis with paravertebral and anterior epidural collections responsible for spinal cord compression next D10 without signs of spinal cord pain. The draining of the cold abscess revealed some whitish pus, in which acid-alcohol resistant bacilli were identified. There was no history of diabetes, renal failure, or long-term treatment with corticosteroids or immunosuppressant’s: HIV serology and viral hepatitis were negative. The blood glucose was normal. The patient was treated with anti-tuberculosis regimen based on: Ethambutol, Rifampicin, Isoniazid, and Pyrazinamide for two months, and then rifampicin and isoniazid for seven months. The outcome was good with the disappearance of the abscess and all the radiological signs. Conclusion: Multifocal TB such as the case reported are uncommon and confined mostly to immunocompromised patients especially those with HIV infection. Because of the clinical polymorphic features of multifocal TB, the diagnosis is usually difficult to make, resulting into delay before beginning of the adequate treatment.

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“…The general role is for the medical treatment, in the form of anti-tuberculosis medications, with a six-month regimen being sufficient in most cases. Surgical intervention may be needed in cases of extensive tissue damage, presence of draining sinuses, or failure of medical treatment [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Extrapulmonary Tuberculosis masquerading as chest wall malignancy: Just never ceases to surprise!

Hussein

Abdelhadi

Elarabi

et al. 2021

IDCases

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With the emergence of the acquired immunodeficiency syndrome, we witnessed a higher incidence of disseminated and extrapulmonary tuberculosis. The infection sites commonly include lymph nodes, pleura, and osteoarticular areas, although any organ can be involved. Given the atypical presentation of the extrapulmonary disease, it poses a significant diagnostic challenge for the physicians; therefore, a high index of suspicion should be maintained, particularly where tuberculosis is endemic. Here we present a case of isolated chest wall tuberculosis in an immunocompetent patient.

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Tuberculosis of Sternum

Cited by 3 publications

References 2 publications

Isolated primary cold abscess of the sternum: a case report

Isolated primary cold abscess of the sternum: a case report

A rare presentation of multifocal tuberculosis in an immunocompetent patient

Extrapulmonary Tuberculosis masquerading as chest wall malignancy: Just never ceases to surprise!

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