An elderly male with tubercular osteomyelitis of the chest wall.

Abstract

Primary tuberculosis of the ribs is rare. A 70-year-old male presented with a 6-month history of a chest wall swelling that ruptured over few weeks to lead to a chronic discharging sinus. He had been administered multiple antibiotics, but the discharge continued. Clinical examination revealed anaemia, cervical lymphadenopathy and a 2-cm splenomegaly. Investigations revealed a normochromic and normocytic anaemia (Hb 7.0 g/dl), an ESR of 60 and a positive tuberculin sensitivity test of 25 mm. Surgical excision of the sinus along with the underlying revealed a caseous rib with histopathological features of a caseating granuloma. The patient was put on antitubercular therapy and is doing well on follow-up.

• Authors: Parvaiz A Koul, M Ashraf, Rafi A Jan, Su Shah, Umar H Khan, Feroze Ahmad, Baseer A Qadri, Sajjad R Bazaz
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2011 (Mar 08 2011) ISSN: 1757-790X [Electronic] England
• PMID: 22707670 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Humans
• Male
• Osteomyelitis (diagnosis, microbiology, therapy)
• Ribs
• Tuberculosis, Osteoarticular (diagnosis, therapy)