Asian Journal of Case Reports in Surgery

Introduction: Sternal tuberculosis (TB) is an exceedingly rare entity, especially in post-operative patients following cardiac surgery. Its clinical presentation often mimics chronic pyogenic infections, leading to delayed diagnosis and inappropriate management.

Aim: To report a rare case of sternal tuberculosis and highlight its clinical and radiological features for early recognition and diagnosis.

Case Report: This case report discusses a case of sternal TB in a 76-year-old male with multiple comorbidities who developed a persistent sinus tract over the sternum years after coronary artery bypass grafting (CABG). The diagnosis was confirmed by acid-fast bacilli (AFB) staining and Mycobacterium culture and sensitivity (C&S) of pus aspirated from the lesion. Prompt initiation of anti-tubercular therapy (ATT) led to improvement of the infection without major surgical intervention.

Conclusion: This case underlines the importance of maintaining a high index of suspicion for TB in chronic sternal wound infections, particularly in high-risk patients. This case also illustrates a rare but important differential diagnosis in post-surgical wound infections—sternal tuberculosis. In high-risk patients with immunosuppression or persistent sternal sinus, TB should be considered, even in the absence of systemic symptoms.