Case report
Extra Pulmonary Tuberculosis Presenting as Midline Sternal Swelling in Infancy: A Case Report
Correspondence Address :
Dr. Ritika Singh,
Postgraduate Student, Department of Paediatrics, Pt. BD Sharma, PGIMS, Rohtak-124001, Haryana, India.
E-mail: ritika16singh@gmail.com
Sternal tuberculosis is an extremely rare form of Extrapulmonary Tuberculosis (EPTB) in infancy, often posing diagnostic challenges due to its nonspecific presentation. A 10-month-old infant presented with a 20-day history of a progressively enlarging, tender anterior chest wall swelling. The child was otherwise asymptomatic and haemodynamically stable. Examination revealed a firm, tender, 2×2 cm swelling over the manubriosternal junction without erythema or fluctuation. Laboratory findings showed lymphocytic leukocytosis and elevated Erythrocyte Sedimentation Rate (ESR); the Mantoux test was negative, and the chest X-ray was unremarkable. Ultrasonography demonstrated a hypoechoic lesion with internal echoes. Contrast-enhanced Computed Tomography (CT) revealed a well-defined, peripherally enhancing hypodense collection adjacent to the sternum, consistent with a cold abscess. Fine-Needle Aspiration Cytology (FNAC) revealed granulomatous inflammation with necrosis, and Ziehl-Neelsen staining confirmed acid-fast bacilli, establishing the diagnosis of sternal tuberculosis. The child completed a course of eight months of Anti-Tubercular Therapy (ATT), and on eight-month follow-up, the lesion completely resolved. Anterior mediastinal swellings encompass a diverse group of neoplastic and non-neoplastic lesions, presenting a diagnostic challenge due to their varied aetiologies and potential for serious complications. Early recognition of sternal tuberculosis in infants requires high clinical suspicion and comprehensive evaluation. Prompt initiation of therapy ensures favourable outcomes.
Acid-fast bacilli, Anterior chest wall, Cold abscess, Granulomatous
DOI: 10.7860/JCDR/2025/79759.21944
Date of Submission: Apr 07, 2025
Date of Peer Review: Jun 23, 2025
Date of Acceptance: Jul 26, 2025
Date of Publishing: Nov 01, 2025
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Apr 13, 2025
• Manual Googling: Jul 22, 2025
• iThenticate Software: Jul 24, 2025 (8%)
ETYMOLOGY: Author Origin
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