Primary Sternal Tuberculosis: A Rare Unhealed Case Treated by Resection and Local Rotational Flap

Abstract

Primary sternal tuberculosis is very rare. Only few cases have been reported in the English-language literature. We present a case of primary sternal tuberculosis that had intractable drainage for 18 months. Diagnosis was confirmed with biopsy, and there were no other tuberculous foci. No improvement was achieved in the status of the wound despite 4 months of chemotherapy. We applied the principles as in bacterial osteomyelitis of sternum, resected the wound and covered it with a pectoralis major musculocutaneous rotational flap. The wound healed, and there was no recurrence 24 months after surgery.

Tubercular Sinus over Manubrium Sterni: A Rare Presentation

“…Treatment of this pathology is also debatable. Majority of the authors believe that antitubercular therapy alone is sufficient but Sarlak, 9 Hajjar 10 and Ford 11 have done resection or debridement along with antitubercular therapy and have shown satisfactory results. In our case, we have performed excision of the tract followed by anti tubercular drugs and patient responded well to this approach.…”

Tuberculosis of the sternum

“…[1][2][3]5 It may be seen as a late complication of pulmonary tuberculosis, 6 or as reactivation of latent loci formed during haematogenous or lymphatic dissemination of primary tuberculosis. 7 Direct extension from mediastinal lymph nodes has also been described.…”

Tuberculous osteomyelitis of the sternum: Successful management with debridement and vacuum assisted closure

“…Due to the often-extensive loss of soft tissue and bony integrity after debridement, rotational tissue flaps can be employed to cover the chest wall defect. A recent report details a single stage procedure, where the sternum was debrided and the defect filled with a tissue flap during the same procedure [6].…”