Ascending aortic aneurysm caused by Mycobacterium tuberculosis

BMC Research Notes

Janakie Fernando¹  Gamini Ranasinghe³  Suneth Karunaratne⁴  Saman Kularatne²  Upul Pathirana² 

[1] Department of Pathology, National Hospital of Sri Lanka, Colombo, Sri Lanka;Department of Respiratory Medicine, National Hospital for Respiratory Diseases, Welisara, Sri Lanka;Department of Cardiothoracic Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka;Department of Cardiology, National Hospital of Sri Lanka, Colombo, Sri Lanka

关键词: Aortic root replacement;    Aortic valve replacement;    Tuberculous aortitis;    Aortic aneurysm;   

Others  :  1232735
DOI  :  10.1186/s13104-015-1667-x

 received in 2015-06-05, accepted in 2015-11-02,  发布年份 2015

【 摘 要 】

Background

Tuberculous aortitis is an unusual presentation of a common disease in Sri Lanka. There were no reported cases of tuberculous aortitis from Sri Lanka. Here we report a case of a 40-year-old woman who developed an ascending aortic aneurysm with severe aortic regurgitation caused by Mycobacterium tuberculosis.

Case presentation

A 40-year-old Sri Lankan female who presented with exertional breathlessness (NYHA II) and weight loss for 4 weeks duration was found to have collapsing pulse and early diastolic murmur at left sternal edge. Transthoracic and transesophageal echocardiogram showed ascending aortic aneurysm with severe aortic regurgitation. Computed tomographic aortography confirmed the diagnosis of aneurysmal dilatation of the ascending aorta. She underwent successful aortic valve replacement and aortic root replacement. The final diagnosis of tuberculous aortitis was made on the basis of macroscopic appearance of inflammation and microscopic confirmation of caseating granuloma. She made a good clinical recovery with category 1 antituberculous chemotherapy.

Conclusions

Although most cases of aortitis are non-infectious in Sri Lanka, an infectious etiology must be considered in the differential diagnosis because therapeutic approaches differ widely. Tuberculous aortitis may be under diagnosed in Sri Lanka, a country with intermediate tuberculosis burden, as the histological or microbiological diagnosis is not possible in most cases. The clinical and radiological diagnostic criteria for tuberculous aortitis need to be set out in case of aneurysmal aortic disease in the absence of apparent etiology.

【 授权许可】

   
2015 Pathirana et al.

【 图 表 】

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