TITLE:
Pulmonary tuberculosis presenting with aortic pseudoaneurysm, diffuse alveolar hemorrhage, and cardiomyopathy: Is there an intriguing relationship?
AUTHORS:
Min Shen, Xuejun Zeng, Xingrong Liu, Bao Liu, Baotong Zhou, Xue Lin, Ran Tian
KEYWORDS:
Pseudoaneurysm; Vasculitis; Thoracic Aorta
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.9,
December
9,
2013
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.