Pulmonary tuberculosis presenting with aortic pseudoaneurysm, diffuse alveolar hemorrhage, and cardiomyopathy: Is there an intriguing relationship?

Min Shen, Xuejun Zeng, Xingrong Liu, Bao Liu, Baotong Zhou, Xue Lin, Ran Tian

Department of Cardiac Surgery, PUMCH, CAMS & PUMC, Beijing, China.
Department of Cardiology, PUMCH, CAMS & PUMC, Beijing, China.
Department of General Internal Medicine, PUMCH, CAMS & PUMC, Beijing, China;.
Department of Infectious Diseases, PUMCH, CAMS & PUMC, Beijing, China.
Department of Rheumatology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
Department of Vascular Surgery, PUMCH, CAMS & PUMC, Beijing, China.

DOI: 10.4236/crcm.2013.29129                

Abstract

A 22-year-old Chinese man presented with fever, cough, hoarseness, neck pain, acute heart failure and hemoptysis. Pulmonary tuberculosis was proved by sputum culture. Chest imaging showed an aortic arch pseudoaneurysm and bilateral ground glass opacities. Echocardiography confirmed cardiomyopathy. With anti-TB drugs, high-dose prednisone and surgery, the life of this patient was successfully prolonged for more than four months. The concomitant disorders of aortic pseudoaneurysm, alveolar hemorrhage and cardiomyopathy in pulmonary tuberculosis are intriguing. We postulate that immune-mediated small vessel vasculitis triggered by pathogens plays an important role in the pathogenesis of this disease, rather than a direct TB infection.

 

Keywords

Pseudoaneurysm; Vasculitis; Thoracic Aorta

Conflicts of Interest

The authors declare no conflicts of interest.

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