Source: International Congress 2015 – Case series and clinical conundrums in TB
Disease area: Respiratory infections

Abstract

Musculoskeletal tuberculosis (TB) occurs in 1-3% of patients with TB, while TB of the chest wall constitutes 1% to 5% of all cases of musculoskeletal TB. We present a case of anterior chest wall tuberculous abscess in childhood. An eleven-month-old boy was admitted with a swelling on the anterior chest wall growing gradually. Physical examination on admission revealed a soft nonfluctuant, non tender lesion over the body of the sternum.



He had received Bacillus Calmette-Guerin (BCG) vaccination at birth, but has no scar. Mantoux test showed induration of 14 mm. Mycobacterial culture of gastric aspirate was negative. Brucella test was negative too. Computed tomography (CT) of the chest revealed soft tissue mass, osteolytic lesion of the sternum and reactive hillar adenopathy.



Histopathologic examination revealed chronic granulomatous inflammation. The patient was treated with isoniazid and rifampin for 6 months. In conclusion TB should be considered in children with undiagnosed chest wall lesions, even if they have been vaccinated with BCG. Adequate anti-tuberculosis treatment can result in a complete recovery. Prompt diagnosis and treatment are important to prevent serious complications.


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Citations should be made in the following way:
Ilija Kirovski (Skopje, FYROM (Macedonia)), Ilija Kirovski. Anterior chest wall tuberculosis in children. Eur Respir J 2015; 46: Suppl. 59, 2766

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