Background : Tuberculosis is still an important world health problem.
The parietal chest wall site in children is a extremely rare form of
tuberculosis. Its diagnosis is often so difficult requiring a surgical
biopsy. Case presentation : We report the case of 1.5-year-old infant,
with no family history of active tuberculosis, who had a swelling of the
anterior chest wall for two months. Physical examination found a
swelling measuring 1.5 cm by 1 cm in relation to the second parasternal
intercostal space, fluctuating in its center, with an inflammatory skin
which fistulized giving a bud-like appearance with a purulent exudate.
Chest X-ray was normal. The thoracic computed tomography showed a
sternal mass responsible for a bone lysis with an infiltration.
Pathology examination of biopsies of the parietal mass confirmed the
diagnosis of caseo-follicular tuberculosis with lesion of tuberculosis
osteitis. Human immunodeficiency virus serology was negative, early
morning gastric aspirates performed on two consecutive days were
negative for acid-fast bacilli, and quantiferon TB Gold in tube test
resulted was also negative. Antitubercular therapy was started with
prolonged regimens for 12 months. She has allowed a favorable outcome
with healing of the thoracic parietal lesion after 6 months. Conclusions
: Diagnosis of chest well tuberculosis is still challenging even if we
are in endemic area and it must be conducted early, his management is
based on both surgey and antitubercular therapy for having a complete
recovery. Prompt diagnosis and treatment are important to prevent
serious complications.