Calvarial tubercular osteomyelitic abscess in an elderly.
Tuberculous osteomyelitis of skull is very rare, even in areas where tuberculosis is endemic. We herein describe an elderly woman who was apparently immunocompetent and presented with left frontal scalp swelling and right cervical lymphadenopathy. CT scan showed irregular bony destruction of the frontal bone. MRI revealed a large extradural, multiseptate, solid-cystic lesion with peripheral enhancement. FNAC from the lesion showed granulomas with caseation suggestive of tuberculosis. The lesion was debrided and she was started on anti-tubercular therapy. Deterioration of liver parameters led to change from primary drugs to liver-friendly, anti-tubercular agents. Though anti-tubercular therapy is the mainstay of calvarial tuberculosis, surgical debridement reduces the bacterial burden and probably hastens recovery.
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Bhavanam Hanuma
BH
Srinivas
Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Megha Shantveer
MS
Uppin
Department of General Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Sateesh
S
Killi
Department of General Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Malladi Venkata Surya
MV
Subbalaxmi
Department of Microbiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Madhusudan
M
Patil
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Alugolu
A
Rajesh
Abscess; calvarium; osteomyelitis; scalp; tuberculosis
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