Tuberculosis-induced osteomyelitis of the right distal tibia in a healthy male Saudi infant: a case report

Abstract

Background: Tuberculosis (TB) is a challenging disease; however, it is preventable and curable in most cases. In 2022, TB was the second most common single infection leading to death worldwide after coronavirus disease. Almost 10 million people get infected with TB every year. TB manifests clinically in two types: pulmonary and extrapulmonary; the pulmonary type is the most common. Case presentation: A 17-month-old medically free male infant was referred to our institution with right distal leg pain, swelling and skin changes, started 1 month ago. Since then, both pain and swelling worsened and led to limping. The father denied any history of recent trauma, fever, cough, night sweating, infections, contact with sick patients, skin rashes in other body parts, or any other systematic changes. The baby was delivered at full term by cesarian-section due to placenta previa, with a birth weight of 3500 g, Prenatal and postnatal history is unremarkable. The patient was vitally stable and appeared healthy with no dysmorphic features. He was able to bear weight on his feet; however, his gait and walking abilities could not be assessed. Local examination showed swelling, erythema, and tenderness over the right distal tibia with an intact range of motion. The patient was admitted and initial investigations were done for him. After close observation and multiple investigations, a diagnosis of TB-induced right tibial osteomyelitis was made, and first-line management was initiated. Conclusion: This report highlights the importance of orthopedic surgeons in considering TB-induced osteomyelitis in the differential diagnosis of vague musculoskeletal symptoms.