Department of Pediatrics, Catholic University of the Sacred Heart - A. Gemelli Hospital, 00168 Rome, Italy.
Ital J Pediatr. 2012 Apr 17;38:12. doi: 10.1186/1824-7288-38-12.
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.
壁胸部结核是儿童结核病中一种极为罕见的表现形式。我们报告了一例 15 个月大的女孩，其最初被认为是肿瘤性起源的胸壁病变，最终被诊断为胸壁结核，采用手术清创和特定抗结核治疗。该女孩的 25-羟维生素 D 水平无法测量，这是活动性结核病发展的一个日益被认识到的危险因素。据我们所知，在英文文献中，没有类似的在如此年幼婴儿中描述的病例。这个病例强调了在低结核病负担国家中也可能会遇到结核病及其不同表现，这是由于不断增加的移民流动造成的。详细的病史是做出诊断的关键。此外，我们的病例证实了 TB 和低 25-羟维生素 D 水平之间可能存在非偶然关系，指出了在所有 TB 患者中测量其水平并考虑在特定抗结核治疗之外进行补充的重要性。
