BREASTBONE TUBERCULOSIS IN MODERN CONDITIONS (CLINICAL CASE)
Keywords:
bone-joint tuberculosis, tuberculosis mycobacteria, sternal tuberculosis, literature, pusAbstract
Bone-joint tuberculosis accounts for 10-25% of extrapulmonary tuberculosis, and the involvement of the sternum in tuberculosis is a rare clinical form even in countries with high tuberculosis prevalence. A thorough search of literature, according to keywords, "primary tuberculosis of the sternum" and "primary tuberculous osteomyelitis of the sternum" in the PubMed database yielded 30 and 22 articles, respectively. A clinical case was analyzed: a woman, 23 years old. She turned to the hospital for a tumor on the anterior chest wall. Upon examination, a large swelling with a diameter of 12.5 cm, soft, painless, without fever, fluctuating, is visible. The pus was aspirated and examined. The pus was negative for acid-resistant bacilli (ACB), but the nucleic acid test using a cartridge amplification test for Mycobacterium tuberculosis was positive and sensitive to rifampicin. According to research by modern scientists, radiological signs may initially be absent upon admission, and symptoms, abscesses, or fistulas may appear long before imaging methods detect them. Conclusion. Isolated primary sternal osteomyelitis caused by M. tuberculosis is still rare, despite the high prevalence of tuberculosis in endemic countries.
References
Garg R.K., Malhotra H.S., Kumar N. Spinal Tuberculosis: Still a Great Mimic // Neurol India. – 2019. – Vol. 67, № 6. – P. 1402–1404. – DOI: https://doi.org/10.4103/0028-3886.273618
Heyde C.E., Lübbert C., Wendt S., Rodloff A., Völker A., von der Höh N.H. Spinal Tuberculosis // Z Orthop Unfall. – 2022. – Vol. 160, № 1. – P. 74–83. – DOI: https://doi.org/10.1055/a-1285-4994
Wang B., Gao W., Hao D. Current Study of the Detection and Treatment Targets of Spinal Tuberculosis // Curr Drug Targets. – 2020. – Vol. 21, № 4. – P. 320–327. – DOI: https://doi.org/10.2174/1389450120666191002151637
Васильева И.А., Тестов В.В., Стерликов С.А. Эпидемическая ситуация по туберкулезу в годы пандемии COVID-19 – 2020–2021 гг. // Туберкулёз и болезни лёгких. – 2022. – Т. 100, № 3. – С. 6–12. – DOI: https://doi.org/10.21292/2075-1230-2022-100-3-6-12
Карпина Н.Л. Диагностика туберкулеза: основные принципы и современные возможности // Вестник центрального НИИ туберкулеза. – 2019. – Спецвып. № S1. – С. 181–190. – DOI: https://doi.org/10.7868/S2587667819050947
Савоненкова Л.Н., Рузов В.И., Анисимова С.В., Васильева Т.С., Дунаев В.С., Колчин Д.В. Особенности эпидемиологии и клинических проявлений туберкулёзного спондилита в Ульяновской области // Туберкулёз и болезни лёгких. – 2020. – Т. 98, № 2. – С. 30–34. – DOI: https://doi.org/10.21292/2075-1230-2020-98-2-30-34
Севастьянова Е.В., Черноусова Л.Н. Современные алгоритмы микробиологической диагностики туберкулеза // Туберкулёз и болезни лёгких. – 2018. – Т. 96, № 7. – С. 11–17. – DOI: https://doi.org/10.21292/2075-1230-2018-96-7-11-17
Советова Н.А., Васильева Г.Ю., Соловьева Н.С., Журавлёв В.Ю., Баулин И.А. Туберкулёзный спондилит у взрослых (клинико-лучевые проявления) // Туберкулёз и болезни лёгких. – 2014. – № 2. – С. 10–14.
Шелкова Е.С. Диагностика туберкулеза с использованием кожных иммунологических тестов. Реальность и перспектива // Медицинский алфавит. – 2017. – Т. 1, № 7. – С. 14–19.
