%0 Journal Article
%T Chest wall TB and low 25-hidroxy-vitamin D levels in a 15-month-old girl
%A Danilo Buonsenso
%A Benedetta Focarelli
%A Maria Scalzone
%A Antonio Chiaretti
%A Claudia Gio¨¨
%A Manuela Ceccarelli
%A Piero Valentini
%J Italian Journal of Pediatrics
%D 2012
%I BioMed Central
%R 10.1186/1824-7288-38-12
%X Tuberculosis (TB) of bones and joints accounts for about 10% of all extrapulmonary TB infections [1,2]. In developing countries, 1-5% of children less than 10 years of age with untreated primary infection due to Mycobacterium tuberculosis (Mtb) develop osteoarticular TB [1,3]. The spine is the most frequently affected site (40-60%), followed by methapyses of long bones, upper extremity bones and non-weight-bearing bones [3]. The infection reaches bones through a lymphohematogenous route, although direct spread from infected lymph nodes may occur [4]. Parietal chest wall TB is rare and rib TB is even rarer [5,6], constituting 1-3% of bone and joint TB [7].Chest wall TB needs to be differentiate from benign and malignant tumors (chondroma, osteochondroma, fibrous dysplasia, lipoid granuloma, chondrosarcoma, myeloma multiplex) [8], metastatic carcinoma, lymphoma or other kinds of infection [9-12].The diagnosis of chest wall TB is often delayed due to lack of specific symptoms and signs and an indolent course [13] and less than 50% of patients have a concomitant active pulmonary TB [8,14]. Radiologic findings vary depending on the stage at presentation [1,3]. Acid fast bacilli (AFB) and cultures of bone are positive in up to 75% of cases, and histopathology is often diagnostic [8].The treatment of choice of chest wall TB is still debated, nevertheless the majority of described cases have been treated with surgical debridement (or excision based on lesion extension) and antitubercular therapy. Epidemiological and in vitro studies have found increasing evidences about a link between active TB and low 25-hidroxy-vitamin D (25-OH-D) levels, 25-OH-D replacement has been recently proposed as adjunctive therapy for TB treatment [15,16]. Nevertheless, the potential benefits of vitamin D as adjunctive therapy in mycobacterial infections are uncertain [17,18].We present the case of a 15 month-old girl, with not-measurable 25-hidroxy-vitamin D (25-OH-D) levels, presenting with a c
%U http://www.ijponline.net/content/38/1/12