A rare case of pediatric tubercular osteomyelitis of pubis

Abstract

Background: The skeletal system is the second most common site of extrapulmonary tuberculosis. Most commonly tuberculosis is seen in the weight bearing joints of the body like hip, spine, knee etc., involvement of the pubis symphysis and pelvic girdle is very rare, and the diagnosis is also frequently delayed due to slow course of disease and varied symptomatology. Case report: We present a case of an 8-year-old child who presented with a inguinal swelling accompanied with intermittent fever and an elevated ESR and total leukocyte count. Fluid analysis was positive for Gene Xpert and patient was started on Category I Anti tubercular drug therapy. The patient showed good clinical recovery within 6 weeks of starting the medication and complete healing at end of 18 months. Conclusion: Tuberculosis of the pubis is one of the rarest pathologies to be reported and subtle points need to be kept in the mind to diagnose it early. Pubic osteomyelitis should be considered in every patient who experiences pubic pain which exacerbates on walking. Biopsy and cultures are mandatory to differentiate between tubercular and non -tubercular organisms. Excellent outcomes can be achieved by starting Anti-tubercular chemotherapy immediately and completing a full course of the drugs. This case report is unique since never in the literature before, has tubercular osteomyelitis of pubis been documented in the pediatric age group.

Keywords

• Case report
• Tubercular osteomyelitis
• Pelvic girdle osteomyelitis
• Pubic tuberculosis
• Conservative treatment