Choremis and his co-worker reported four cases, all of them infants, who during their treatment for tuberculous meningitis developed spontaneous fractures of the lower extremities without any evidence of localized tuberculous on the area of the-fractures.
Spontaneous fractures of the sternum also have been described in adult patients with tuberculosis.
Report of Case
A 4 years and one month old Korean Boy was admitted to Severance Hospital in 1957 with vomiting, severe headache, convulsions, and drowsiness of one day´s duration following a couple of weeks general malaise c mild fever.
Tuberculin reaction was positive. Rigidity of the neck and Kernig´s sign were noted, and a spinal tap revealed 201 rig per 100 cc protein, 21 mg per 100 cc sugar and 542 cells, predominantly lymphocytes. The patient was intensively treated with streptomycin, isoniazid, PAS, and cortisone intramuscularly and made a satisfactory recovery.
Four months after admission painful swelling of left foot was noted following stepping down from his bed. An x-ray revealed fracture of the end of the first metatarsal bone. This fracture healed with calus formation after three and a half month immobilization.
The patient was discharged with satisfactory recovery after four and a half month admission.
Three months after complete healing of the fracture a painful swelling of right lower extremity was noted again following a incident of minor falling down.
An X-ray study revealed a linear fracture of the right tibia and this fracture-healed with immobilization.
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