Conquering the Conquered: Sternal Tuberculosis Osteomyelitis with HIV Infection

In HIV infected individuals extra pulmonary tuberculosis is more common than pulmonary tuberculosis and hematological dissemination of the bacilli is one of the major reasons for this to occur. Also, it is seen that in these individuals the disease progresses over weeks rather than in months or years. The most common presentations being tuberculosis of lymph nodes, pleura, pericardium with or without dissemination [1]. Tubercular involvement of the sternum in the form of osteomyelitis is rare [3]. The presentation is in the form of indolent, painless course without constitutional symptoms like evening low grade rise of temperature, loss of appetite, weight loss, night sweats or sometimes with a more aggressive course causing painful bone destruction with constitutional symptoms [4]. While the involvement of bone marrow in patients with HIV infection and presentation as osteomyelitis is uncommon [5]. However, in case of sternum the superficial location of the wound brings it to notice of the patient [6].