Isolated Tuberculosis of The Sternum Detected with GeneXpert: A Case in an Adult Girl
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 3
Abstract
Sternal tuberculosis is a form of osteoarticular tuberculosis. It remains a rare localization, whose diagnosis is based on bacteriological and anatomopathological samples. The treatment is medical and surgical, and the prognosis is better with the antibacillary treatment. We report a case of sternal tuberculosis in an 18-year-old girl with no pathological history who presented with a parasternal right swelling and whose Bacteriological samples was favorable for tuberculosis according to GeneXpert test and the histological analysis revealed a granulomatous lesion without caseous necrosis.She is Miss S.A, aged 18, with no notable pathological history, including no tuberculosis or concept of tuberculous contusion, which has had a parasternal right swelling for a month. The examination of the swelling found a parasternal right mass just below the clavicle opposite the first intercostal space, painful on palpation, with redness, without cutaneous fistulization. An initial chest x-ray was requested returning without abnormality, in particular no lysis opposite, or associated parenchymatous involvement, with an infectious assessment negative made of a blood cell parameters and C- reactive protein, A thoracic computed tomography was performed objectifying an osteolytic lesion with intraosseous sequestration at the right super-lateral part of the sternum (Figure 1), associated with infiltration of the soft tissues and two abscesses, the first at right intercostal muscle level, and the second in the anterior parietal area (Figure 2). Flattening of the swelling was performed in the patient, with bacteriological and histological samples of the abscess. The direct examination and the culture of the pus came back negative. However, the molecular study of the collection by GeneXpert objectified a tuberculosis. The anatomopathological study revealed a granulomatous lesion, but without caseous necrosis. The patient was put on antibacillary treatment with good clinical progress.Tuberculosis is an infectious disease that is still rife in Morocco in endemic form. It is most often due to Mycobacterium Tuberculosis. Osteoarticular tuberculosis mainly affects the spine, hip or knee [1]. Localization at the chest wall represents less than 5% of osteoarticular tuberculosis, and whose sternal involvement remains more rare, and estimated at 1 to 2% [2-3]. Dissemination occurs either by a hematogenous or lymphatic pathway or by direct contiguity from mediastinal adenopathy’s or pleural empyema [4- 5]. The clinical aspects are varied, especially in the absence of signs of tuberculous impregnation, or other associated pulmonary or extra-pulmonary sites suggestive of tuberculosis [6].
Authors and Affiliations
Harmouchi H, Lakranbi M, Belliraj L, Issoufou I, Ouadnouni Y, Smahi M
Keywords
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- EP ID EP589165
- DOI 10.26717/BJSTR.2018.07.001494
- Views 159
- Downloads 0
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