Olazábal AI, Pereira JK

Language: Spanish
References: 18
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ABSTRACT

Background: tubercular osteomielitis of the skull is a rare entity that only occurs in the 0.01 % of patients infected by Mycobacterium Tuberculosis, although this frequency of presentation increases significantly in people who are carriers of some degree of immunodeficiency. The clinical picture is usually insidious at the onset of the disease and is characterized by the presence of local pain of progressive intensity.
Objective: to present a less frequent clinical case of chronic osteomielitis of the skull secondary to an infection by Mycobacterium Tuberculosis.
Case presentation: 5 years old patient with history of pain and increase in the volume of the interparietal region of the skull. On physical examination, an increase in the volume with fluctuation of the mentioned region and irregular bone defect was stated. A skull X-ray was ordered which revealed an osteolitic lesion of the skull. An exeresis of the bone was performed. Vancomicin and Ceftriaxone were used during the two first weeks of the postoperative recovery. The clinical evolution was not satisfactory until a positive culture of Mycobacterium Tuberculosis was obtained. Then, specific treatment for tuberculosis was indicated. The patient's evolution was favourable five weeks after the initial diagnosis.
Conclusions: osteomielitis of the skull is rare, but can be seen, especially, in countries with high prevalence of the disease. Its early diagnosis and treatment can avoid intracranial complications.

REFERENCES

1. Strauss DC. Tuberculosis of flat bones of the vault of the skull. Surg Gynaecol Obstet 1933; 57(6):384-98.

2. Barton C J. Tuberculosis of the vault of the skull. Br J Radiol 1961; 34(3):286-90.

3. Jadhav RN, Palande DA. Vault tuberculosis. Neurosurgery. 1999;45(8):1345-50.

4. Meng CM, WU YK. Tuberculosis of the flat bones of the vault of the skull. Bone Joint Surg 1942;34(10):341-53.

5. Gupta PK, Kolluri VRS, Chandramouli BA, et al. Calvarial tuberculosis: A report of two cases. Neurosurgery 2010;25(4):830-3.

6. Patankar T, Varma R. Radiographic findings in tuberculosis of the calvarium Neuroradiology 2009; 42(3):518-21.

7. Krishnan A, Prasad S, Desai K, Castillo M. Radiographic in tuberculosis. Neuroradiology 2006; 22(1): 16-22.

8. Raut AA, Nagar AM, Muzumhar D, Chawla AJ, Narlawar RS, Fattepurkar S, Bhatgadde VL. Imaging features of calvarial tuberculosis: a study of 42 cases. Am J Neuroradiol 2009;25(7): 409-14.

9. Sencer S, Sencer A, Aydýn K, Hepgül K, Poyanlý A, Minareci: Imaging in tuberculosis of the skull and skull-base: case report. Neuroradiology 2007; 45(9): 160-63.

10. Sharma R, Tyagi I, Kumar R, Phadke RV. Tuberculosis of the skull. A case report and review of the literature. Neurosurg Rev 2011; 23(12): 104-06.

11. Shatad AH, Rahman NU, Obaideen AM, Ahmed I, Zahman AU: Cranial-Epidural Tuberculosis Presenting as a Scalp Swelling: Surg Neurol 2010; 61(5): 464-67.

12. Álvarez S Mc, Cabe WR. Extrapulmonary tuberculosis revisited: a review of experience at Boston City and other hospitals. Medicine (Baltimore) 1984; 63(6): 25.

13. Blumberg HM, Burman WJ, Chaisson RE. American Thoracic Society/ centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med. 2008; 167(2): 603.

14. Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician 2011;72(8):1761-8.

15. Ravi M, Kartikeya S. Cytodiagnosis of tuberculosis of the skull by fine needle aspiration cytology: a case report. Pathology 2010; 32(9): 213-5.

16. De Castro CC, de Barros NG, Campos ZM, Cerri GG. CT scans of cranial tuberculosis. Radiol. Clin. North. Am. 1995; 33 (4): 753-69.

17. Stones, D. K, Schoeman, C. J. Calvarial Tuberculosis. J Trop Pediatr.2008; 50(4): 361-364

18. Wohaibi Al-M, Russel NA, Omojola M, Feriyan Al-A. Tuberculosis of the skull. J Neurosurg 2011;92(10):1065-69.