An elderly male with tubercular osteomyelitis of the chest wall.
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.
Department of Internal Medicine and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India. parvaizk@gmail.com
Parvaiz A
PA
Koul
M
M
Ashraf
Rafi A
RA
Jan
Su
S
Shah
Umar H
UH
Khan
Feroze
F
Ahmad
Baseer A
BA
Qadri
Sajjad R
SR
Bazaz
D000368:Aged; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D012272:Ribs; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis / Q000628:therapy