title: Tuberculous sternal osteomyelitis.
abstract: A 32-year-old female patient with systemic lupus erythematosus presented with 1 month of nocturnal subjective fevers, night sweats, poor appetite, malaise, 8-kg weight loss, and a 6-cm painful sternal mass. She had normal vital signs with a physical examination notable only for the presence of a fluctuating sternal mass. A computed tomographic scan of the thorax showed a 67 × 32 × 27-mm sternal mass associated with severe sternal osteomyelitis (Fig. 1); then a surgical drainage was performed, and abundant caseous material was removed, leaving a penrose drain (Fig. 2). Histologic examination of the bone tissue revealed extensive necrosis and granulomas with multinucleated giant cells. The bone, secretion, and soft tissue were negative for acid-fast bacillae on Ziehl-Neelsen stain; but culture grew Mycobacterioum tuberculosis, and she was started on 4 first-line antituberculosis medications, showing rapid symptomatic improvement, and was discharged 4 weeks after admission (Fig. 3).
authors.affiliation: Infectious Diseases Section, Internal Medicine Department, University of Antioquia Medical School, Calle 15 Sur # 48-130, Medellín, Colombia. Electronic address: kataju@hotmail.com.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Cataño
authors.affiliation: Internal Medicine Department, CES University Medical School, Medellín, Colombia.
authors.forename: Daniela
authors.initials: D
authors.lastname: Galeano
authors.affiliation: Internal Medicine Department, CES University Medical School, Medellín, Colombia.
authors.forename: Juan Camilo
authors.initials: JC
authors.lastname: Botero
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D004322:Drainage; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D010019:Osteomyelitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D013249:Sternum / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy
chemical_list: D000995:Antitubercular Agents