Multifocal tuberculosis revealed by a sternal swelling in an immunocompetent child

Abstract

Tuberculosis (TB) is one of the most common pathogens of bacterial lung infections specially in underdevelopoed nations like morocco where the incidence of TB was 97 cases per 100,000 person in 2019. Thanks to its national TB prevention and control plan, Morocco was able to acheive a remarkable progress in management of TB with 80% reduction in the total number patients diagnosed with TB between 1980 and 2018. The national plan also allowed to reach and maintain a therapeutic rate above 86% since 2002. extrapulmonary TB primarily affects the primary weight bearing joints and the spine. Sternal TB is a rare clinical condition accounting for 1% of all musculoskeletal TB cases. Due to its rarity and the lack of awareness of the clinicals presentations, The diagnosis of sternal TB can be quite complex. we describe the case of a 14 year old moroccan patient consulting in the military hospital mohammed V, Rabat with central chest pain for four months. The pain was not associated to breathing, physical exercise or eating. with a history of asthenia, fever, and weight loss. A ct scan of the chest showed a destructive lesions of the sternum. thereafter, a chirurgical biopsy was performed and enabled to confirm the microbiological diagnosis of tuberculosis thanks to the realization of the RT-PCR. The anti-tuberculosis therapy was given to the patient who had complete resolution of symptoms. This condition should be included in the differential diagnosis of chronic chest pain that mimics costochondritis particularly in patients from endemic areas.