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CC BY-NC-ND 4.0 · Asian J Neurosurg 2016; 11(04): 445
DOI: 10.4103/1793-5482.145334
CASE REPORT

Calvarial tubercular osteomyelitic abscess in an elderly

Bhavanam Srinivas
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh
,
Megha Uppin
1   Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh
,
Sateesh Killi
2   Department of General Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh
,
Malladi Subbalaxmi
2   Department of General Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh
,
Madhusudan Patil
3   Department of Microbiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh
,
Alugolu Rajesh
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh
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Tuberculous osteomyelitis of skull is very rare, even in areas where tuberculosis is endemic. We herein describe an elderly woman who was apparently immunocompetent and presented with left frontal scalp swelling and right cervical lymphadenopathy. CT scan showed irregular bony destruction of the frontal bone. MRI revealed a large extradural, multiseptate, solid-cystic lesion with peripheral enhancement. FNAC from the lesion showed granulomas with caseation suggestive of tuberculosis. The lesion was debrided and she was started on anti-tubercular therapy. Deterioration of liver parameters led to change from primary drugs to liver-friendly, anti-tubercular agents. Though anti-tubercular therapy is the mainstay of calvarial tuberculosis, surgical debridement reduces the bacterial burden and probably hastens recovery.

Key-words:

Abscess - calvarium - osteomyelitis - scalp - tuberculosis


Publication History

Article published online:
20 September 2022

© 2016. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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