An Overview of Disease and Health Research Vol. 9

Background: Skeletal tuberculosis constitutes about 1٪ of all cases. Usually, spine and limb bones are involved. Tuberculosis is endemic in many developing countries, including Bangladesh, where the disease remains highly prevalent. Tubercular osteomyelitis of the skull is a rare entity; therefore, diagnosis is rarely suspected. Given the rarity of the condition, only a few patients with Tubercular osteomyelitis of the skull have been reported in the medical literature.

Case Report: This chapter reports one such rare case of an atypical calvarial skull osteomyelitis in a 14-year-old female who presented with swelling on the right frontoparietal region for 3 months. CT scan of the brain and bony window revealed a lytic bony lesion at the right parietal bone with an associated epidural soft tissue component at the right parietal top, causing compression over adjacent parenchyma- possibly eosinophilic granuloma or chronic osteomyelitis. Haematological test reveals no abnormality except ESR 61mm in 1^st hour with a normal chest X-ray. The patient was treated surgically by excision of the lesion with cranioplasty using synthetic bone cement. After surgical treatment, the specimen was sent for histopathology, which showed granulomatous inflammation histologically consistent with tuberculosis. She was treated with antitubercular therapy as per the national tuberculosis guideline.

Conclusion: Our Case highlights all these aspects of skull tuberculosis with a review of the available literature relevant to skull tubercular osteomyelitis.