{"id":"aae0567b-c166-4cdc-8469-cdb051234534","slug":"empirical-antitubercular-therapy-even-in-endemic-area-should-be-started-with-caution-missed-case-of-calvarial-epidermoid-presenting-with-discharging-sinus","title":"Empirical antitubercular therapy even in endemic area should be started with caution: Missed case of calvarial epidermoid presenting with discharging sinus","authors":["Sushanta K. Sahoo","Harsimrat Bir Singh Sodhi","Pravin Salunke","Mandeep S. Ghuman"],"abstract":"Background: Spontaneous discharging sinus due to a bony lesion can occur in endemic areas, where tubercular osteomyelitis is often a leading cause. However, some bony lesions may mimic tubercular osteomyelitis, leading to diagnostic challenges. Summary: This letter presents a case of an 11-year-old child with an intradiploic epidermoid of the sphenoid ridge, initially misdiagnosed and treated as tuberculosis. The patient did not respond to empirical antitubercular therapy, prompting further imaging and surgical intervention, which ultimately led to the correct diagnosis. Conclusion: The case highlights the importance of careful evaluation of radiological and histopathological findings in diagnosing discharging sinuses from the calvaria. Misdiagnosis can lead to unnecessary treatment, emphasizing the need for accurate diagnostic practices even in endemic areas. Keywords: discharging sinus, epidermoid, tuberculosis, antitubercular therapy, diagnosis, calvarial lesions, sphenoid ridge","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/aae0567b-c166-4cdc-8469-cdb051234534/featured/hero-1782420799907.png","publishDate":"2016-04-13T00:00:00.000Z","doi":"10.4103/2152-7806.180301","categories":["Letter to the Editor"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2016/04/6682/SNI-7-40.pdf"}