Multifocal tuberculosis revealed by a sternal swelling in an immunocompetent child
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Tuberculosis (TB) is one of the most common pathogens of bacterial lung infections, especially in underdeveloped nations like Morocco, where the incidence of TB was 97 cases per 100 000 persons in 2019. Thanks to its national TB prevention and control plan, Morocco was able to achieve remarkable progress in the management of TB with an 80% reduction in the total number of patients diagnosed with TB between 1980 and 2018. The national plan also allowed us to reach and maintain a therapeutic rate above 86% since 2002. Sternal TB is a rare clinical condition accounting for 1% of all musculoskeletal TB cases. Due to its rarity and the lack of awareness of clinical presentations, the diagnosis of sternal TB can be quite complex. We describe the case of a 14-year-old Moroccan patient consulting in the Military Hospital Mohammed V-Rabat with central chest pain for 4 months which was not associated with breathing, physical exercise or eating. The patient also had a history of asthenia, fever and weight loss. A computed tomography scan of the chest showed a destructive lesion of the sternum. Afterward, a chirurgical biopsy was performed and enabled to confirm the microbiological diagnosis of TB with the realization of the real-time PCR. The antitubercular therapy was given to the patient who had complete resolution of symptoms. This condition should be included in the differential diagnosis of chronic chest pain that mimics costochondritis particularly in patients from endemic areas.
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Thank you for submitting your revised manuscript to Access Microbiology and applying the reviewer suggestions. I am pleased to let you know that your manuscript has been accepted for publication. Congratulations!
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Thank you very much for submitting your manuscript to Access Microbiology. It has now been reviewed by three experts in the field, whose comments are attached below. In general terms, all reviewers agree that this case report is a valuable contribution to the literature, but a number of corrections are needed, which are indicated in their reports. Please pay special attention to recommendations concerning the correct use of English language and the format and precision of data presentation. Please provide a revised version of this manuscript (including a tracked changes version) and a point-by-point response to the reviewer comments within one month
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Comments to Author
Than you presenting this valuable work. In general there are some punctuation defects in the whole manuscript which needs revision. Some comments are raised during revision of the manuscript. 1. Lack of references in most of the introduction 2. some sentences are too long e.g., line 84-87, 112-117, 122-125 Please ONLY put comments for the Author(s) in here
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
…
Comments to Author
Than you presenting this valuable work. In general there are some punctuation defects in the whole manuscript which needs revision. Some comments are raised during revision of the manuscript. 1. Lack of references in most of the introduction 2. some sentences are too long e.g., line 84-87, 112-117, 122-125 Please ONLY put comments for the Author(s) in here
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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Comments to Author
Title: Multifocal tuberculosis revealed by a sternal swelling in an immunocompetent child Authors: Ghizlane Chehrastane et al Summary: This is an interesting case report about an immunocompetent child who was diagnosed with a multifocal tuberculosis that was revealed through a sternal swelling. The manuscript is well written but with few obvious mistakes (such as wrong spellings, misplaced commas, full stops, sentence being started with a small letter instead of capital letter, etc.) that could have been corrected, had the manuscript been edited/revised before submission and require minor corrections as follows: Line 11- the sentence has a few mistakes, and needs to be corrected, = underdeveloped is incorrectly written, Morrocco is written in small letter, ….97 cases per 100 000 person in 2019 …
Comments to Author
Title: Multifocal tuberculosis revealed by a sternal swelling in an immunocompetent child Authors: Ghizlane Chehrastane et al Summary: This is an interesting case report about an immunocompetent child who was diagnosed with a multifocal tuberculosis that was revealed through a sternal swelling. The manuscript is well written but with few obvious mistakes (such as wrong spellings, misplaced commas, full stops, sentence being started with a small letter instead of capital letter, etc.) that could have been corrected, had the manuscript been edited/revised before submission and require minor corrections as follows: Line 11- the sentence has a few mistakes, and needs to be corrected, = underdeveloped is incorrectly written, Morrocco is written in small letter, ….97 cases per 100 000 person in 2019 should be persons NOT person. Line 14- acheive should be achieve Line19-start the sentence after a full stop not a comma, and also with a capital letter Line 20- the first letter of a country should always be written in CAPS and consistently throughout the manuscript. Also, this should apply to the name of a hospital. Line 22-the statement written here that starts from line 21 incomplete, and should be corrected/rephrased. Line 24- from this line, tuberculosis is inconsistently written throughout the manuscript Line 62- the authors write RT-PCR performed with the GeneXpert-Cepheid automated system, what are they referring to with RT-PCR? Is this reverse transcriptase PCR or real time PCR? This should be clarified by writing in full,. Also, the GeneXpert-Cepheid automated system- there are many tests that this automated system do, (e,g. it can identify C. difficile, COVID-19, etc) what the authors lack to do here, is to indicate the type of test/s done with the Xpert system, and should also indicate how is Mtb and rifampicin drug resistance/susceptibility detected and this should be clarified, because this will lead to a clear interpretation of "Trace Mtb results" that are being reported in this statement. Line 63-the organism should be written in italics Line 64 -authors should also indicate the name of the liquid medium in the MGIT tube as this is not its name. Line 67-figure 3A is extremely blurry, such that in the end, it looks more like artefacts than serpentine chords, the authors can replace this figure if it is still possible. Line 77- authors should refer to the CT scan figure of the cervical-dorsal-lumbar spine that was performed. Line 90-BCG- should not be abbreviated since it's only written twice in the manuscript, this applies for any other terms that might not have been written more than three times in the entire manuscript.
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
-
Comments to Author
The Authors should correct the spelling and grammar mistakes, particularly in the Abstract part. There are mistakes in the laboratory data presentation of the patient (Some values are wrongly given e.g. TLC or there is no unit in many data), which should be corrected. Otherwise, the manuscript presenting this rare case is well written
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript …
Comments to Author
The Authors should correct the spelling and grammar mistakes, particularly in the Abstract part. There are mistakes in the laboratory data presentation of the patient (Some values are wrongly given e.g. TLC or there is no unit in many data), which should be corrected. Otherwise, the manuscript presenting this rare case is well written
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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