Primary Calvarial Tuberculosis (PCT) presenting as cold abscess of the scalp: A report of two cases

Calvarial tuberculosis is a rare manifestation of extra pulmonary tuberculosis. Primary calvarial tuberculosis, with no evidence tuberculosis elsewhere in the body is a rarer entity. We discuss the clinical presentation and management of two such patients subjected to investigations for any evidence of tuberculosis elsewhere in the body. Radiological images including CT scan and MRI of the brain were utilized. Histopathological examination of the granulation tissue and lytic bone established this diagnosis. A prompt surgery and anti tubercular therapy planned for patients and improved after a year. Early diagnosis and appropriate management plan of calvarial tuberculosis require high index of suspicion and knowledge. Radiological investigations help in diagnosis and preoperative planning in such cases. Definitive diagnosis is established with demostration of acid fast bacilli (AFB), culture and sensitivity, and histopathological examination. Prompt surgery and antitubercular therapy are the treatment of choice .