A Diagnostic Quandary of Calvarial Tuberculosis: A Case Report

  • Sushan Homagain Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
  • Suraj Shrestha Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
  • Sushil Sah Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
  • Gopal Sedain Department of Neurosurgery, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Keywords: calvaria; Mycobacterium; osteomyelitis; Tuberculosis.

Abstract

Primary Calvarial Tuberculosis, a rare entity of skull is even rarer after second decade of life in a healthy person without evidence of tuberculosis elsewhere in the body. Most of the cases are often misdiagnosed as osteomyelitis/syphilis/bony metastasis.

We report a case of primary skull tuberculosis in 26-year-old male with complains of headache and swelling in the right frontal region with no history of previous tuberculosis. The patient was operated and the histopathological examination of excised tissue was suggestive of tubercular pathology. The patient is doing well after anti-tubercular therapy.

Being a rare disease, tubercular osteomyelitis of skull bones is often missed and misdiagnosed due to lack of clinical suspicion and slow growth of mycobacterium cultures. Histopathological examination of biopsy material and demonstration of acid-fast bacilli in the pus are helpful for diagnosis and early management of the disease.

Published
2019-06-30
How to Cite
Homagain, S., Shrestha, S., Sah, S., & Sedain, G. (2019). A Diagnostic Quandary of Calvarial Tuberculosis: A Case Report. Journal of Nepal Medical Association, 57(217). https://doi.org/10.31729/jnma.4319
Section
Case Reports