Radiological Evaluation of a Rare Case of Rib Caries and Cold Abscess in a Young Male Patient With Miliary Tuberculosis: A Case Report With Review of Literature

Abstract

Rib caries with a cold abscess is a rare presentation of tuberculosis (TB) and is tricky to diagnose. It is rarer in young patients, especially in conjunction with active miliary TB. We present one such case of a 23-year-old male patient who presented with swelling over the left lower chest. Rib caries and cold abscess were initially detected by ultrasonography and elastography. The rib involvement and the extent of the cold abscess were further evaluated on a computed tomography scan, which also showed active pulmonary miliary TB. The patient was treated by aspiration of the cold abscess and anti-tuberculosis therapy. The fact that the patient had no history of diabetes, alcoholism, human immunodeficiency virus infection, or immunodeficiency disorder increases the rarity of this case. This case highlights the role of imaging in diagnosing rib caries, cold abscess, and miliary TB.

Keywords: cold abscess; computed tomography; elastography; miliary tuberculosis; radiography; rib caries; ultrasonography.