Abstract
Background: Sternal tuberculosis is an uncommon form of extrapulmonary tuberculosis and it can be a diagnostic challenge for pediatricians.
 Case Presentation: We report the case of a young 14-year-old boy, who had a gradually increasing swelling of the sternum over the past 2 months preceded by weight loss, asthenia and night sweats. Radiological, histological, and microbiological investigations confirmed it as a case of sternal tuberculosis (TB). He was managed with surgical debridement during the sternal biopsy and quadruple antituberculosis therapy with good response.
 Discussion: Tuberculosis (TB) of sternum is one of the rarest forms of skeletal tuberculosis. The incidence of sternal tuberculosis has been calculated to be <1.5% amongst osteo-articular tuberculosis, with very few cases reported in infants. The diagnosis is based on histological and bacteriologic arguments.
 Conclusion: Tuberculous osteomyelitis of the sternum is a rare finding in children. Our aim is to increase awareness around atypical presentations and the uncommon involvement of the sternum in musculoskeletal tuberculosis.
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