La tuberculose de la paroi thoracique : à propos d’un cas au CHU Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar

Tuberculosis of the chest wall: report of a case at the Joseph Ravoahangy Andrianavalona Teaching Hospital, Antananarivo, Madagascar Abstract Background/rationale. Tuberculosis is a public health issue. Extra-pulmonary presentations are rare and sometimes hard to diagnose and manage. Here, we report a case of tuberculosis of the chest wall in a 28-year-old man in order to discuss the mechanism, diagnostic and therapeutic problems posed by this rare localization. Description. The patient presented with wall swelling discovered after physical effort. Imaging was in favor of an abscess or infected hematoma. The excisional surgery established the tuberculous origin which was confirmed by histology. Anti-tuberculosis treatment during 9 months completed the surgical treatment and led to the patient's recovery. Discussion/conclusion. The rarity of this localization of tuberculosis should be investigated. Etiological treatment must be instituted and regular monitoring scheduled to avoid recurrence. Key words: Tuberculosis, Chest wall, Diagnosis, Therapy, Hospital, Antananarivo, Madagascar, Indian Ocean Resume Introduction/justification. La tuberculose est un probleme de sante publique. Les presentations extra-pulmonaires sont rares et de diagnostic parfois delicat. Nous rapportons un cas de tuberculose de la paroi thoracique chez un homme de 28 ans afin de discuter le mecanisme, les problemes diagnostique et therapeutique poses par cette localisation rare. Description. Le patient presentait une tumefaction parietale decouverte a l’issue d’un effort physique. L’imagerie etait en faveur d’un abces ou d’un hematome infecte. La chirurgie d’exerese a permis d’etablir l’origine tuberculeuse qui a ete confirmee par l’histologie. Un traitement antituberculeux institue pendant 9 mois a complete le traitement chirurgical et conduit a la guerison du patient. Discussion/conclusion. La rarete de cette localisation de la tuberculose doit etre recherchee. Un traitement etiologique doit etre institue et un suivi regulier programme pour eviter les recidives. Mots cles : Tuberculose, Paroi thoracique, Diagnostic, Traitement, Hopital, Antananarivo, Madagascar, Ocean Indien