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Unusual presentation of more common disease/injury
An elderly male with tubercular osteomyelitis of the chest wall
  1. Parvaiz A Koul1,
  2. M Ashraf2,
  3. Rafi A Jan2,
  4. SU Shah2,
  5. Umar H Khan2,
  6. Feroze Ahmad2,
  7. Baseer A Qadri2,
  8. Sajjad R Bazaz2
  1. 1Department of Internal Medicine and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
  2. 2Department of Internal Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
  1. Correspondence to Dr Parvaiz A Koul, parvaizk{at}gmail.com

Summary

Primary tuberculosis of the ribs is rare. A 70-year-old male presented with a 6-month history of a chest wall swelling that ruptured over few weeks to lead to a chronic discharging sinus. He had been administered multiple antibiotics, but the discharge continued. Clinical examination revealed anaemia, cervical lymphadenopathy and a 2-cm splenomegaly. Investigations revealed a normochromic and normocytic anaemia (Hb 7.0 g/dl), an ESR of 60 and a positive tuberculin sensitivity test of 25 mm. Surgical excision of the sinus along with the underlying revealed a caseous rib with histopathological features of a caseating granuloma. The patient was put on antitubercular therapy and is doing well on follow-up.

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  • Competing interests None.

  • Patient consent Obtained.

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