A 15-year-old girl from Iraq presented with a swelling on her left chest wall without signs of infection. Surgical drainage and resection of the involved left 3rd costal cartilage was performed, which revealed tuberculous osteomyelitis. Tuberculosis is a public health problem in developing countries and can present as a cold abscess of the chest wall that is difficult to diagnose without biopsy. Drainage and debridement provide treatment while postoperative antibiotic therapy combined with surgery can prevent complications and recurrence.

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
Cold Abscess of the
Chest Wall in a Young
Girl
Prof. Abdulsalam Y Taha
College of Medicine
University of Sulaimani
2022
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2. The Case
 A 15-years old girl, from
Sulaymaniyah, Iraq presented with
a fluctuant swelling over left
anterior chest wall without signs
of acute inflammation. Surgical
drainage of pus was performed
with resection of the involved left
3rd costal cartilage (?Tuberculous
osteomyelitis).
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6. Comments
 Tuberculosis is a public health problem in
developing countries. Tuberculosis of the chest
wall is rare and often presents as cold abscess
(to differentiate from pyogenic abscess) or
pseudotumoral mass whose diagnosis is difficult
and often requires a surgical biopsy [1].
 Drainage of chest wall abscess and complete
debridement provide adequate treatment. Post-
operative anti-bacillary therapy should be
combined with surgical procedures to minimize
local complications and recurrence of infection
[1].
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7. Bibliography
[1] Kabiri EH, Alassane EA, Kamdem
MK, Bhairis M, Amraoui M, El Oueriachi
F, El Hammoumi M. Tuberculous cold
abscess of the chest wall: A clinical and
surgical experience. Report of 16
cases(Case series). Ann Med Surg
(Lond). 2020 Feb 13;51:54-58. doi:
10.1016/j.amsu.2020.02.001. PMID:
32099646; PMCID: PMC7029049.
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