Tubercular osteomyelitis of skull, a case report

Abstract

Cranial tuberculosis is a rare entity, which starts with an infection of the spinal cord and spreads to the external and internal plates of the skull, causing destruction of the bone and the formation of granulation tissue causing a collection of purulent discharge, edema and pain in the affected area. Diagnosis requires the demonstration of acid-fast bacilli in the smear specimen by Ziehl-Neelsen staining and the presence of a histopathological caseous granuloma. Treatment may be medical or surgical depending on the complexity of the pathology. We report the case of a 45-year-old male patient, who presented with an open wound in the left parietal region, caused by a history of craniotomy due to cranioencephalic trauma 6 years ago. The culture of the lesion described was positive for acid-fast bacilli, and the patient received antituberculosis therapy with good clinical response. This is an unusual case that is reported for knowledge and to define diagnostic and therapeutic conducts before an atypical presentation of extrapulmonary tuberculosis.