Top

Published in:

Open Access 01-12-2012 | Case report

Chest wall TB and low 25-hidroxy-vitamin D levels in a 15-month-old girl

Authors: Danilo Buonsenso, Benedetta Focarelli, Maria Scalzone, Antonio Chiaretti, Claudia Gioè, Manuela Ceccarelli, Piero Valentini

Published in: Italian Journal of Pediatrics | Issue 1/2012

Abstract

Parietal chest wall tuberculosis is an extremely rare manifestation of tuberculosis (TB) in children. We present the case of a 15 month-old girl presenting with a chest wall lesion initially thought to be of neoplastic origin and eventually diagnosed as chest wall TB, which was treated with surgical debridement and specific antitubercular therapy. The girl had not-measurable 25-hidroxy-vitamin D levels, an increasingly recognized risk factor for the development of active TB. To our knowledge, in the English literature there are no similar described cases in such young infants. This case highlight the possibility of dealing with TB and its different manifestations also in low TB burden countries, due to continuously increasing migration flows. A detailed history is a key point to reach the diagnosis. Moreover, our case confirm the possible non casual relationship between TB and low 25-hidroxy-vitamin D levels, pointing out the importance of measuring its levels in all TB patients and considering its supplementation in addition to specific antitubercular therapy.

Available only for authorised users

Williams KD: Tuberculosis and other unusual infections. Campbell's operative orthopedics. 1992, St. Louis: Mosby, 1: 626-640. 9

Reider HL, Snider DE, Cauten GM: Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis. 1990, 141: 347-351.CrossRef

Correa AG: Unique aspects of tuberculosis in the pediatric population. Clin Chest Med. 1997, 18: 89-98. 10.1016/S0272-5231(05)70358-0.CrossRefPubMed

Kaur S, Thami GP, Gupta PN, Kanwar AJ: Recalcitrant scrofuloderma due to rib tuberculosis. Pediatric dermatology. 2003, 20: 309-3012. 10.1046/j.1525-1470.2003.20406.x.CrossRefPubMed

Mathlouthi A, Ben M'Rad S, Merai S, Friaa T, Mestiri I, Ben Miled K, Djenayah F: Tuberculosis of the thoracic wall. Presentation of four personal cases and review of the literature. Rev Pneumol Clin. 1998, 54: 182-186.PubMed

Trombati N, Afif H: El Farouki Z, Bahlaoui A, Aichane A, Bouayad Z: Parietal thoracic tuberculosis in the absence of immunosuppression by HIV infection. Rev Mal Respir. 2001, 18: 301-304.PubMed

Chang JH, Kim SK, Kim SK, Chuung KY, Shin DH, Joo SH, Choe KO: Tuberculosis of the ribs: a recurrent attack of rib caries. Yonsei Med J. 1992, 33: 374-378.CrossRefPubMed

Agrawal V, Joshi MK, Jain BK, Mohanty D, Gupta A: Tuberculotic osteomyelitis of rib-a surgical entity. Interact Cardiovasc Thorac Surg. 2008, 7: 1028-1030. 10.1510/icvts.2008.179127.CrossRefPubMed

Ormerod LP, Grundy M, Rahman MA: Multiple tuberculosis bone lesions simulating metastatic disease. Tubercle. 1989, 70: 305-307. 10.1016/0041-3879(89)90027-5.CrossRefPubMed

10.

FitzGerald R, Hutchinson CE: Tuberculosis of the ribs: computed tomographic findings. Br J Radiol. 1992, 65: 822-824. 10.1259/0007-1285-65-777-822.CrossRefPubMed

11.

Dwivedi S, Jain AK, Agarwal MP, Aneja A: Rib tuberculosis simulating Tietze's syndrome. Trop Doct. 1998, 28: 117-PubMed

12.

Chang GH, Kim SK, Lee WY: Diagnostic issues in tuberculosis of the ribs with a review of 12 surgically proven cases. Respirology. 2009, 4: 249-253.CrossRef

13.

Newton P, Sharp J, Barnes KL: Bone and joint tuberculosis in greater Manchester 1969-1979. Ann Rheum Dis. 1982, 41: 1-6.PubMedCentralCrossRefPubMed

14.

Asnis DS, Niegowska A: Tuberculosis of the rib. Clin Infect Dis. 1997, 24: 1018-1019. 10.1093/clinids/24.5.1018.CrossRefPubMed

15.

Nnoaham KE, Clarke A: Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol. 2008, 37: 113-119.CrossRefPubMed

16.

Martineau AR, Nhamoyebonde S, Oni T: Reciprocal seasonal variation in vitamin D status and tuberculosis notifications in Cape Town, South Africa. Proc Natl Acad Sci USA. 2011, 108: 19013-19017. 10.1073/pnas.1111825108.PubMedCentralCrossRefPubMed

17.

Lias AF, Dunn J, Huntington MK: Tuberculosis and profound hypovitaminosis d in an infant. Pediatr Infect Dis J. 2011, 30: 1008-1010. 10.1097/INF.0b013e3182271947.CrossRef

18.

Yamshchikov AV, Desai NS, Blumberg HM: Vitamin D for treatment and prevention of infectious diseases: a systematic review of randomized controlled trials. Endocr Pract. 2009, 15: 438-449. 10.4158/EP09101.ORR.PubMedCentralCrossRefPubMed

19.

Martini M, Ouahes M: Bone and joint tuberculosis: a review of 652 Cases. Orthopedics. 1988, 2: 861-866.

20.

Tatelman M, Drouillard EJP: Tuberculosis of the ribs. Am J Roentgenol Radium Ther Nucl Med. 1953, 70: 923-935.PubMed

21.

Faure E, Souliamas R, Riquet M: Cold abscess of the chest wall: a surgical entity?. Ann Thorac Surg. 1998, 66: 1174-1178. 10.1016/S0003-4975(98)00770-X.CrossRefPubMed

22.

Johnson MP, Rothstein E: Tuberculosis of the rib. J Bone Joint Surg. 1952, 34: 878-882.PubMed

23.

Lee G, Im JG, Kim JS, Kang HS, Han MC: Tuberculosis of the ribs: CT appearance. J Comput Assist Tomogr. 1993, 17: 363-366. 10.1097/00004728-199305000-00004.CrossRefPubMed

24.

Gupta AK, Uppal SS: Unusual rib destruction in pleuropulmonary tuberculosis. Indian J Chest Dis. 1991, 33: 87-89.

25.

Ip M, Chen NK, So SY, Chiu SW, Lam WK: Unusual rib destruction in pleuropulmonary tuberculosis. Chest. 1989, 95: 242-244. 10.1378/chest.95.1.242.CrossRefPubMed

26.

Jain V, Sen B, Agarwal M, Maini L, Mehtani A: Tuberculosis of Rib and Lung Presenting as Subcutaneous Emphysema. Pediatr Infect Dis J. 2006, 25: 662-663.CrossRefPubMed

27.

Sun Y, Zhang Y, Lu Z: Clinical study of polymerase chain reaction technique in the diagnosis of bone tuberculosis. Zhonghua Jie He He Hu Xi Za Zhi. 1997, 20: 145-148.PubMed

28.

Jaiswal A, Nigam V, Jain V, Kapoor S, Dhaon BK: Multifocal skeletal TB or disseminated bone TB. Tropical Doctor. 2006, 36: 178-180. 10.1258/004947506777978091.CrossRefPubMed

29.

Khalil A, Le Breton C, Tassart M, Korzec J, Bigot J, Carette M: Utility of CT scan for the diagnosis of chest wall tuberculosis. Eur Radiol. 1999, 9: 1638-1642. 10.1007/s003300050900.CrossRefPubMed

30.

Bishara J, Gartman-Israel D, Weinberger M, Maimon S, Tamir G, Pitlik S: Osteomyelitis of the ribs in the antibiotic era. Scand J Infect Dis. 2000, 32: 223-227. 10.1080/00365540050165839.CrossRefPubMed

31.

Yao HS: Experience in 712 cases of tuberculosis of chest wall by surgical treatment. Zhonghua Wai Ke Za Zhi. 1990, 28: 354-355. 382PubMed

32.

Chen SC, Huang SC, Wu CT: Non-spinal tuberculous osteomyelitis in children. J Formos Med Assoc. 1998, 97: 26-31.PubMed

33.

Newton SM, Brent AJ, Anderson S, Whittaker E, Kampmann B: Paediatric Tuberculosis. Lancet Infect Dis. 2008, 8: 498-510. 10.1016/S1473-3099(08)70182-8.CrossRefPubMed

34.

Holick MF, Binkley NC, Bischoff-Ferrari HA: Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011, 96: 1911-1930. 10.1210/jc.2011-0385.CrossRefPubMed

35.

Liu PT, Stenger S, Tang DH: Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol. 2007, 179: 2060-2063.CrossRefPubMed

36.

Realegeno S, Modlin RL: Shedding light on the vitamin D-tuberculosis-HIV connection. Proc Natl Acad Sci USA. 2011, 108: 18861-18862. 10.1073/pnas.1116513108.PubMedCentralCrossRefPubMed

37.

Martineau AR, Wilkinson RJ, Wilkinson KA: A single dose of vitamin D enhances immunity to mycobacteria. Am J Respir Crit Care Med. 2007, 176: 208-213. 10.1164/rccm.200701-007OC.CrossRefPubMed

Title: Chest wall TB and low 25-hidroxy-vitamin D levels in a 15-month-old girl
Authors: Danilo Buonsenso
Benedetta Focarelli
Maria Scalzone
Antonio Chiaretti
Claudia Gioè
Manuela Ceccarelli
Piero Valentini
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Italian Journal of Pediatrics / Issue 1/2012
Electronic ISSN: 1824-7288
DOI: https://doi.org/10.1186/1824-7288-38-12

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chest wall TB and low 25-hidroxy-vitamin D levels in a 15-month-old girl

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2012

Juvenile granulosa cell tumor of the testis: prenatal diagnosis and prescrotal approach

Unusual pediatric co-morbility: autoimmune thyroiditis and cortico-resistant nephrotic syndrome in a 6-month-old Italian patient

Should a hospitalized child receive empiric treatment with acyclovir?

Development and validation of serum bilirubin nomogram to predict the absence of risk for severe hyperbilirubinaemia before discharge: a prospective, multicenter study

Congenital nasal pyriform aperture stenosis: diagnosis and management

Research statistics in Atopic Eczema: what disease is this?