Infantile Sternal Tuberculosis

Background: Tuberculosis (TB) of sternum is one of the rarest forms of skeletal TB. Incidence of sternal TB has been calculated to be <1.5% amongst osteo-articular TB, with very few cases reported in infants. Due to its subtle signs and symptoms, early diagnosis of this entity becomes a challenge. Clinical Description: We reported case of 6-month-old boy who presented with complaints of progressively increasing swelling at the anterior chest wall. Radiological, histological, and microbiological investigations helped establish a diagnosis of infantile sternal TB. Management: Drainage of the lesion and excision of affected necrotic tissue was done. Culture and histopathological examination were suggestive of tubercular osteomyelitis of sternum. Weight adjusted antitubercular medications were given for 1 year. At 3 years of follow-up, the lesion had healed well without any recurrence, sinus formation or local deformity. Conclusions: High index of suspicion and detailed diagnostic work up are required for early diagnosis and management of infantile sternal tuberculous osteomyelitis.