Destructive rib lesions in an HIV sero-negative male: an unusual presentation of tuberculosis in a high tuberculosis prevalence setting

Summary Tuberculosis (TB) of the rib is a very rare form of skeletal TB and its diagnosis may be difficult because of a low index of suspicion by clinicians. The presentation often mimics malignant disease clinically and radiologically and diagnosis may only be confirmed by tissue biopsy. We present...

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Bibliographic Details
Published in:Tropical doctor 2012-10, Vol.42 (4), p.217-218
Main Authors: Nakiyingi, Lydia, Bwanika, John M, Lukande, Robert, Kirenga, Bruce, Mwambu, Tom P, Worodria, William, Okot-Nwang, Martin
Format: Article
Language:English
Subjects:
Adult
Bacterial diseases
Biological and medical sciences
General aspects
HIV Seronegativity
Human bacterial diseases
Human immunodeficiency virus
Human viral diseases
Humans
Infectious diseases
Male
Medical sciences
Mycobacterium
Ribs - diagnostic imaging
Ribs - pathology
Tomography, X-Ray Computed
Tuberculosis and atypical mycobacterial infections
Tuberculosis, Osteoarticular - diagnostic imaging
Tuberculosis, Osteoarticular - pathology
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Summary Tuberculosis (TB) of the rib is a very rare form of skeletal TB and its diagnosis may be difficult because of a low index of suspicion by clinicians. The presentation often mimics malignant disease clinically and radiologically and diagnosis may only be confirmed by tissue biopsy. We present a 32-year-old HIV-negative man who presented with a three-month history of progressively worsening pleuritic chest pain, weight loss, fatigue, anorexia and low-grade fever with night sweats. A chest computerized tomography (CT) scan showed destructive lesions in the right fourth and seventh ribs with no pulmonary lesions. A diagnosis of TB of the rib was made after surgical resection and histopathology of the affected tissue. There was significant improvement when anti-TB therapy was initiated. This case report emphasizes the importance of a high index of suspicion of TB in patients presenting with destructive bone lesions in regions with high prevalence of TB.
ISSN:0049-4755
1758-1133
DOI:10.1258/td.2012.110342