Chandanwale Shirish Sahebrao, Raj Akshi, Singh Madhuri, Kundlia Aakriti
Department of Pathology, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India.
J Glob Infect Dis. 2023 Aug 11;16(1):33-35. doi: 10.4103/jgid.jgid_64_23. eCollection 2024 Jan-Mar.
Extra pulmonary tuberculosis is on the rise worldwide, and younger patients, are females. And people from Asia and Africa are at high risk. Sternoclavicular TB is extremely rare, even in countries that have a high prevalence of TB. It can be in the absence of pulmonary TB. It has a varied clinical presentation. Painless chest wall swelling can be the presenting symptom of sternoclavicular diagnosis. Ultrasonography and high-resolution computed tomography can identify the nature of the lesion and the extent of bone involvement. Aspiration from the swelling or histopathology examination is mandatory for diagnosis. Caseous necrosis is diagnostic of TB. Detection of acid-fast bacilli in smears or tissue or molecular methods is required for definitive diagnosis. A high degree of clinical suspicion is required for early diagnosis. The treatment of thoracic TB is the subject of controversy. Anti-tubercular drugs are the mainstay of treatment. Surgical intervention is basically for flattening cold abscesses and removing infected tissue, including affected bones and cartilage.
肺外结核病在全球范围内呈上升趋势，年轻患者居多，且以女性为主。来自亚洲和非洲的人群风险较高。胸锁关节结核极为罕见，即使在结核病高发国家也是如此。它可能不存在肺结核。其临床表现多样。无痛性胸壁肿胀可能是胸锁关节结核诊断的首发症状。超声检查和高分辨率计算机断层扫描可确定病变性质和骨受累范围。对肿胀部位进行抽吸或组织病理学检查是诊断的必要手段。干酪样坏死可诊断为结核病。涂片、组织或分子方法检测抗酸杆菌是明确诊断所必需的。早期诊断需要高度的临床怀疑。胸壁结核的治疗存在争议。抗结核药物是治疗的主要手段。手术干预主要是为了使寒性脓肿变平并清除感染组织，包括受累的骨骼和软骨。
