Abstract |
Sternal osteomyelitis secondary to mycobacterium tuberculosis (TB) is rare, with <1% of musculoskeletal TB cases reported. The recurrent scenario is unresolving infection and delayed diagnosis. A 75-year-old woman presented with a persistently discharging sternal wound 10 months after coronary artery bypass grafting. Multiple antibiotics, wound debridement and removal of sternal wires was attempted; however, progression to local osteomyelitis and sternoclavicular joint destruction occurred. Tissue biopsies were finally sent for mycobacterial culture testing positive for Mycobacterium tuberculosis High index of suspicion is necessary for diagnosis of sternal tuberculosis, confirmed through timely microbiological investigations. MRI may identify soft-tissue and bone oedema characteristic of TB osteomyelitis. This patient had no TB risk factors. The source of infection is unclear and warrants further investigation. Sternal TB osteomyelitis is uncommon and largely reported through case reports, thus management and indications for surgery remain undefined. If sensitive, standard TB four-drug regimen may be trialled.
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Authors | Victoria Rizzo, Yousuf Salmasi, Michael Hunter, Pushpinder Sidhu |
Journal | BMJ case reports
(BMJ Case Rep)
Vol. 2018
(Mar 05 2018)
ISSN: 1757-790X [Electronic] England |
PMID | 29507030
(Publication Type: Case Reports, Journal Article)
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Copyright | © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. |
Chemical References |
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Topics |
- Aged
- Antitubercular Agents
(therapeutic use)
- Biopsy
- Cardiopulmonary Bypass
(adverse effects)
- Debridement
- Delayed Diagnosis
- Humans
- Mycobacterium tuberculosis
(isolation & purification)
- Osteomyelitis
(diagnostic imaging, microbiology, therapy)
- Sternum
(diagnostic imaging, microbiology)
- Surgical Wound Infection
(complications, therapy)
- Tomography, X-Ray Computed
- Tuberculosis, Osteoarticular
(diagnostic imaging, microbiology, therapy)
- Ultrasonography
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