RESUMEN
Mycotic aneurysm in a visceral artery due to tuberculosis (TB) is a rare occurrence. Imaging plays a critical role in its diagnosis. Over the last few years, minimally invasive interventional radiological treatment has replaced more invasive surgical procedures. Here, we report a case presenting with abdominal pain, diagnosed with jejunal artery mycotic pseudoaneurysm (PSA) secondary to TB, managed by endovascular coiling. Coil embolisation of the superior mesenteric artery branch was done using three coils, closing both the front door, back door and sac of the mycotic aneurysm. Visceral PSA following TB infection is rare and can be fatal if left untreated. Coil embolisation is a minimally invasive procedure with a high success rate and comparatively fewer complications.
Asunto(s)
Aneurisma Falso , Aneurisma Infectado , Embolización Terapéutica , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/diagnóstico por imagen , Embolización Terapéutica/métodos , Aneurisma Infectado/terapia , Aneurisma Infectado/diagnóstico por imagen , Masculino , Yeyuno/irrigación sanguínea , Aortitis/terapia , Aortitis/microbiología , Procedimientos Endovasculares/métodos , Persona de Mediana Edad , Tuberculosis Cardiovascular/terapiaAsunto(s)
Atrios Cardíacos , Imagen Multimodal , Tuberculosis Cardiovascular , Humanos , Ecocardiografía , Granuloma/diagnóstico por imagen , Atrios Cardíacos/diagnóstico por imagen , Cardiopatías/diagnóstico por imagen , Imagen por Resonancia Cinemagnética/métodos , Imagen Multimodal/métodos , Tomografía Computarizada por Rayos X/métodos , Tuberculosis Cardiovascular/diagnóstico por imagenRESUMEN
La tuberculosis miocárdica es una localización infrecuente que, en general, se caracteriza por cuadros clínicos silentes. Su diagnóstico se basa en la alta sospecha clínica y hallazgos inespecíficos en las imágenes cardíacas, pero la histopatología continúa siendo el estándar de oro para establecer el diagnóstico. La terapia antituberculosa ha sido exitosa, presentando mejoría radiológica y clínica en la mayoría de los casos. Presentamos el caso de una infección miocárdica por Mycobacterium tuberculosis en un hombre de 34 años que consultó por un cuadro de disnea de varias semanas de evolución. Se pesquisó un derrame pleural derecho y pericárdico grave, sin signos de taponamiento cardíaco. La RPC para M. tuberculosis en líquido pleural resultó positiva. El estudio histológico de pericardio y miocardio evidenció una pericarditis crónica y una inflamación granulomatosa, no necrosante, con células gigantes multinucleadas en el tejido miocárdico. Se estableció el diagnóstico de tuberculosis pleural, pericárdica y miocárdica y se inició tratamiento antituberculoso, presentando una mejoría clínica significativa.
Myocardial tuberculosis is a rare location that is generally characterized by silent clinical pictures. Diagnosis is based on high clinical suspicion and some nonspecific findings on cardiac imaging, but histological findings remain the gold standard. Treatment with standard antitubercular drugs llave been successful, presenting radiological and clinical improvement in most cases. We report a case of myocardial infection by Mycobacterium tuberculosis in a 34-year-old man, who presented with several weeks of dyspnea and evidence of right pleural effusion and severe pericardial effusion, without signs of cardiac tamponade. PCR for M. tuberculosis was positive in pleural fluid. The histologic study of pericardium and myocardium showed myocardial fibers with non-necrotizing granulomatous inflammation with multinucleated giant cells. Due to all the above, a diagnosis of pleural and myocardial tuberculosis was made, and tuberculosis treatment was started with significant clinical improvement.
Asunto(s)
Humanos , Masculino , Adulto , Tuberculosis Cardiovascular/diagnóstico por imagen , Tuberculosis Pleural/diagnóstico por imagen , Tuberculosis Cardiovascular/patología , Tuberculosis Pleural/patología , Tomografía Computarizada por Rayos X , Disnea/etiología , Mycobacterium tuberculosis , MiocardioRESUMEN
A gentleman in his late 30s presented with a history of evening rise of temperature and generalised malaise of 1-week duration. He had associated upper back pain with tingling and numbness of both lower limbs. An unexplained episode of hypotension with hemoptysis propelled a computed tomography (CT) examination of chest which was suggestive of a pseudoaneurysm of the posterior wall of descending thoracic aorta in the vicinity of the Pott's spine with a prevertebral and paravertebral abscess, for which he was referred to vascular surgeons.Tubercular involvement of vasculature is a rare disease, aortic involvement even rarer. Less than 50 cases of vertebral tuberculosis with tubercular thoracic aortic aneurysm have been reported in the medical literature, but the disease carries a colossal mortality and morbidity.After a multidisciplinary teamwork, thoracic endovascular aortic repair was done for exclusion of the aneurysmal segment, with simultaneous antitubercular and broad-spectrum antibiotic chemotherapy. The patient recuperated well.
Asunto(s)
Aneurisma Falso , Aneurisma de la Aorta Torácica , Aortitis , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Tuberculosis Cardiovascular , Tuberculosis , Masculino , Humanos , Aneurisma Falso/complicaciones , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Aortitis/complicaciones , Aortitis/diagnóstico por imagen , Aortitis/cirugía , Aneurisma de la Aorta Torácica/complicaciones , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Tuberculosis Cardiovascular/complicaciones , Tuberculosis Cardiovascular/diagnóstico por imagen , Tuberculosis/complicaciones , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugíaRESUMEN
Acquired tuberculosis continues to be a challenge worldwide. Although tuberculosis has been considered a global public health emergency, it remains poorly controlled in many countries. Despite being primarily a pulmonary disease, tuberculosis could involve the heart. This systematic review is part of the "Neglected Tropical Diseases and Other Infectious Diseases Involving the Heart" (the NET-Heart Project) initiative from the Interamerican Society of Cardiology. This project aims to review the cardiovascular involvement of these heterogeneous diseases, advancing original algorithms to help healthcare providers diagnose and manage cardiovascular complications. In tuberculosis, pericardium involvement is relatively common, especially in AIDS, and tuberculosis is the most common cause of constrictive pericarditis in endemic countries. Myocarditis and aortitis by tuberculosis are rare. Clinical manifestations of cardiovascular involvement by tuberculosis differ from those typically found for bacteria or viruses. Prevailing systemic symptoms and the pericarditis diagnostic index should be taken into account. An echocardiogram is the first step for diagnosing cardiovascular involvement; however, several image modalities can be used, depending on the suspected site of infection. Adenosine deaminase levels, gamma interferon, or polymerase chain reaction testing could be used to confirm tuberculosis infection; each has a high diagnostic performance. Antituberculosis chemotherapy and corticosteroids are treatment mainstays that significantly reduce mortality, constriction, and hospitalizations, especially in patients with HIV. In conclusion, tuberculosis cardiac involvement is frequent and could lead to heart failure, constrictive pericarditis, or death. Early detection of complications should be a cornerstone of overall management.
Asunto(s)
Manejo de la Enfermedad , Miocarditis/microbiología , Tuberculosis Cardiovascular/epidemiología , Salud Global , Humanos , Morbilidad/tendencias , Miocarditis/epidemiología , Miocarditis/terapia , Tuberculosis Cardiovascular/microbiología , Tuberculosis Cardiovascular/terapiaAsunto(s)
Aneurisma Falso/microbiología , Aneurisma Infectado/microbiología , Aneurisma Ilíaco/microbiología , Mycobacterium tuberculosis/aislamiento & purificación , Arteria Esplénica/microbiología , Tuberculosis Cardiovascular/microbiología , Adulto , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Aneurisma Infectado/diagnóstico por imagen , Aneurisma Infectado/terapia , Antituberculosos/uso terapéutico , Embolización Terapéutica , Humanos , Aneurisma Ilíaco/diagnóstico por imagen , Aneurisma Ilíaco/terapia , Masculino , Arteria Esplénica/diagnóstico por imagen , Resultado del Tratamiento , Tuberculosis Cardiovascular/complicaciones , Tuberculosis Cardiovascular/diagnóstico , Tuberculosis Cardiovascular/tratamiento farmacológicoAsunto(s)
Angina de Pecho/diagnóstico , Insuficiencia Cardíaca/diagnóstico , Neoplasias Cardíacas/diagnóstico , Defectos del Tabique Interventricular/diagnóstico por imagen , Infarto del Miocardio/diagnóstico por imagen , Transposición de los Grandes Vasos/diagnóstico por imagen , Tuberculoma/diagnóstico , Tuberculosis Cardiovascular/diagnóstico , Adulto , Angina de Pecho/etiología , Procedimiento de Blalock-Taussing , Angiografía por Tomografía Computarizada , Angiografía Coronaria , Diagnóstico Diferencial , Fibroma/complicaciones , Fibroma/diagnóstico , Insuficiencia Cardíaca/etiología , Neoplasias Cardíacas/complicaciones , Defectos del Tabique Interventricular/cirugía , Humanos , Imagen por Resonancia Magnética , Infarto del Miocardio/etiología , Miofibroma/complicaciones , Miofibroma/diagnóstico , Transposición de los Grandes Vasos/cirugía , Tuberculoma/complicaciones , Tuberculosis Cardiovascular/complicacionesRESUMEN
BACKGROUND: Tuberculosis of the myocardium is an extremely rare entity with few published case reports. Diagnosis is often delayed, and outcomes are unfavorable: particularly when cardiac involvement has been the presenting entity. METHODS: Four patients, aged 24-51 years, presented with life-threatening ventricular arrhythmia (VA). None had a previous history of tuberculosis or any structural heart disease. Electrocardiogram during sinus rhythm and Echocardiography did not show any gross abnormality. All patients underwent contrast-enhanced computer tomography of thorax and cardiac magnetic resonance imaging. Attempts to obtain tissue (cardiac or associated mediastinal lymph nodes) were associated with increased risk to the patients thus indirect evidence of Mantoux skin test and interferon gamma release assay results were used to aid diagnosis. RESULTS: Based on clinicoradiological findings, patients were put on antitubercular therapy (ATT). Supportive therapy included antiarrhythmic drugs (all patients), catheter ablation (two patients), and implantable cardioverter defibrillator (one patient). Arrhythmia suppression was achieved in all patients predischarge. On a follow-up of 2-24 months, none of the patients has had any recurrence of arrhythmia. ATT and antiarrhythmic drug therapy have been stopped in two patients who have completed the 6 months of ATT. Their radiological lesions showed resolution. CONCLUSIONS: Myocardial tuberculosis presenting as life-threatening VA in a rare but definite clinical entity. A high index of suspicion and cardiac imaging can lead to early diagnosis and appropriate treatment that ensures survival in all patients.
Asunto(s)
Cardiomiopatías/diagnóstico , Tuberculosis Cardiovascular/diagnóstico , Adolescente , Adulto , Cardiomiopatías/microbiología , Diagnóstico Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la EnfermedadAsunto(s)
Aneurisma Falso/diagnóstico , Tuberculosis Cardiovascular/diagnóstico , Tuberculosis/diagnóstico , Aneurisma Falso/tratamiento farmacológico , Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Antibióticos Antituberculosos/uso terapéutico , Aorta/diagnóstico por imagen , Aorta/patología , Aorta/cirugía , Bélgica , Implantación de Prótesis Vascular , Terapia Combinada , Angiografía por Tomografía Computarizada , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Enfermedad de la Arteria Coronaria/etiología , Enfermedad de la Arteria Coronaria/cirugía , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Tuberculosis/complicaciones , Tuberculosis/tratamiento farmacológico , Tuberculosis/cirugía , Tuberculosis Cardiovascular/complicaciones , Tuberculosis Cardiovascular/tratamiento farmacológico , Tuberculosis Cardiovascular/cirugíaRESUMEN
A patient with main pulmonary artery mass may have severe symptoms and warrants urgent surgical management, whereas in a stable patient with a diagnosis amenable to medical treatment, medical management should be started while monitoring the size of the lesion. We report a case in which the patient experienced severe right heart dysfunction due to obstruction of the main pulmonary artery, diagnosed as a probable thrombus, and the patient was taken for urgent surgical excision, later diagnosed as tuberculoma on histopathologic examination.
Asunto(s)
Arteria Pulmonar/diagnóstico por imagen , Estenosis de Arteria Pulmonar/etiología , Tuberculoma/complicaciones , Tuberculosis Cardiovascular/complicaciones , Procedimientos Quirúrgicos Vasculares/métodos , Adolescente , Diagnóstico Diferencial , Ecocardiografía , Humanos , Masculino , Arteria Pulmonar/cirugía , Estenosis de Arteria Pulmonar/diagnóstico , Estenosis de Arteria Pulmonar/cirugía , Tuberculoma/diagnóstico , Tuberculoma/cirugía , Tuberculosis Cardiovascular/diagnóstico , Tuberculosis Cardiovascular/cirugíaRESUMEN
An immunocompetent migrant with chest pain was admitted to an Italian hospital. Computed tomography showed a left pectoral abscess and osteomyelitis of the sternum. The infection had spread into the anterior mediastinum near to the pericardium and the heart, where an atrial mass was confirmed by echocardiography. Disseminated tuberculosis was diagnosed.
Asunto(s)
Refugiados , Tuberculosis Cardiovascular/diagnóstico por imagen , Tuberculosis Miliar/diagnóstico por imagen , Adulto , Dolor en el Pecho , Ecocardiografía , Atrios Cardíacos , Humanos , Inmunocompetencia , Masculino , Osteomielitis/diagnóstico por imagen , Esternón , Tomografía Computarizada por Rayos XAsunto(s)
Taquicardia Ventricular , Tuberculosis Cardiovascular/diagnóstico , Tuberculosis Pulmonar , Complejos Prematuros Ventriculares , Antituberculosos/uso terapéutico , Diagnóstico Diferencial , Ecocardiografía/métodos , Electrocardiografía Ambulatoria/métodos , Femenino , Humanos , Imagen por Resonancia Cinemagnética/métodos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/etiología , Resultado del Tratamiento , Tuberculosis Cardiovascular/fisiopatología , Tuberculosis Cardiovascular/terapia , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/terapia , Complejos Prematuros Ventriculares/diagnóstico , Complejos Prematuros Ventriculares/etiologíaAsunto(s)
Infecciones por VIH/complicaciones , Imagen por Resonancia Magnética , Tuberculosis Cardiovascular/diagnóstico por imagen , Tuberculosis Pulmonar/complicaciones , Fármacos Anti-VIH/uso terapéutico , Antituberculosos/uso terapéutico , Diagnóstico Diferencial , Ecocardiografía Doppler en Color , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Humanos , Hallazgos Incidentales , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones , Valor Predictivo de las Pruebas , Factores de Riesgo , Tuberculosis Cardiovascular/microbiología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/microbiologíaRESUMEN
Tuberculous aneurysms of the common iliac artery are rare. Only a few cases have been reported in the literature. We report a new case in a 47-year-old man admitted for abdominal pain and persistent fever. The aneurysm was evoked in the duplex ultrasound scan and confirmed by computed tomographic angiography. The patient underwent an extra-anatomic femorofemoral bypass with a dacron prosthesis and ligation of the aneurysmal artery. The postoperative course was marked by febrile dyspnea related to the tuberculous miliary found on the chest x-ray. Histological analysis of the operative specimens confirmed the tuberculous origin of the aneurysm. The patient was put on antituberculous drugs and the follow-up was uneventful. With a follow-up of four months, the patient was asymptomatic and the bypass was well patent.
Asunto(s)
Aneurisma Infectado/cirugía , Aneurisma Roto/cirugía , Implantación de Prótesis Vascular , Aneurisma Ilíaco/cirugía , Tuberculosis Cardiovascular/microbiología , Tuberculosis Miliar/microbiología , Aneurisma Infectado/diagnóstico por imagen , Aneurisma Infectado/microbiología , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/microbiología , Antituberculosos/uso terapéutico , Prótesis Vascular , Implantación de Prótesis Vascular/instrumentación , Humanos , Aneurisma Ilíaco/diagnóstico por imagen , Aneurisma Ilíaco/microbiología , Ligadura , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Tuberculosis Cardiovascular/diagnóstico , Tuberculosis Cardiovascular/tratamiento farmacológico , Tuberculosis Miliar/diagnóstico , Tuberculosis Miliar/tratamiento farmacológicoRESUMEN
RATIONALE: We present a rare case of multiple tuberculous mycotic aneurysm. Multiple aneurysms caused by tuberculosis (TB) are difficult to treat. Here, we discuss a treatment modality using a microcore stent graft. PATIENT CONCERNS: A 73-year-old man with pain in the back and on the right side of the chest associated with dry cough, presented with an inability to walk since 1-month. DIAGNOSES: A diagnosis of multiple aneurysms caused by TB was made, based on computed tomography (CT) scan and positive T-spot and Xpert tests. INTERVENTIONS: We administered the empirical anti-TB regimen (pyrazinamide, isoniazid, rifampicin, and ethambutol) and performed endovascular repair using microcore stent graft. OUTCOMES: The post-operative hemodynamic analysis indicated that the patient's aneurysms no longer had a risk of rupture, and blood flow in the major branches of the aorta had been maintained. However, the patient could not survive due to a pulmonary infection acquired during recuperation at a local hospital. LESSONS: For multiple tuberculous mycotic aneurysms, anti-TB therapy is inadequate and the microcore stent graft is a feasible option that can improve the hemodynamics in the aneurysms.
Asunto(s)
Aneurisma Infectado/tratamiento farmacológico , Aneurisma Infectado/cirugía , Antituberculosos/uso terapéutico , Tuberculosis Cardiovascular/tratamiento farmacológico , Anciano , Humanos , Masculino , StentsRESUMEN
A definitive diagnosis of tuberculosis serositis (TS) is still challenging. Our preliminary practice found that Serous Fluid Drainage Flocky Precipitate (SFDFP) was a useful testing sample to diagnose TS. We designed this study to assess the diagnostic performance of SFDPF for TS compared with conventional bacteriology methods on serous fluid (SF). A cohort study was conducted from July 2014 to April 2016. Patients with suspected TS were consecutively screened. SF and SFDFP were collected and tested by Ziehl-Neelsen stain, MTB culture, and Xpert/RIF assay. We compared the diagnostic performance of SF and SFDFP in several test settings. Through this study, 85 patients were enrolled, of whom 70 (82.4%) were confirmed TS or highly probable TS, 13 (15.3%) were none-TS and 2 (2.4%) indeterminate results were ruled out. The overall sensitivity using both SFDFP and SF was significantly higher than each (60% vs. 48% and 41%, p < 0.05). SFDFP and SF samples had similar diagnostic performance (p < 0.05). No false positive was detected in this study. We concluded that SFDFP is a reliable testing sample for diagnosing tuberculous serositis. SFDFP may significantly improve the diagnostic yield as a supplement to conventional tests.
Asunto(s)
Técnicas de Diagnóstico Molecular/métodos , Serositis/metabolismo , Tuberculosis Cardiovascular/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Líquidos Corporales/diagnóstico por imagen , Líquidos Corporales/metabolismo , Niño , Preescolar , China , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/genética , Sensibilidad y Especificidad , Serositis/diagnóstico , Serositis/microbiología , Manejo de Especímenes/métodos , Esputo/microbiología , Tuberculosis Meníngea/diagnósticoRESUMEN
BACKGROUND: Extra-pulmonary tuberculosis (EPTB) is defined as any bacteriologically confirmed or clinically diagnosed case of TB involving organs other than the lungs. It is frequently a diagnostic and therapeutic challenge with paucity of data available. The aim of this study was to assess the prevalence of bacteriologically confirmed EPTB; to determine the most affected organs and to evaluate the therapeutic outcome of EPTB patients treated under program conditions in the littoral region of Cameroon. METHODS: A descriptive cross-sectional laboratory-based epidemiological survey was conducted from January 2016 to December 2017 and 109 specimens from 15 of the 39 diagnosis and treatment centers in the littoral region were obtained. Two diagnostic methods (Gene Xpert MTB and culture (LJ and MGIT) were used for EPTB diagnosis. Determine HIV1/2 and SD Biolinewere used for HIV diagnosis. Confirmed EPTB cases were treated following the national tuberculosis guide. RESULTS: The prevalence of bacteriologically confirmed EPTB was 41.3% (45). All 45 cases were sensitive to rifampicin. Males were predominately more infected [26 (57.8%)] likewise the age group 31-45 years with 15 (33.3%) cases. The overall prevalence for HIV was 33.6% (36). HIV infection was present in 28.9% (13) of patients with EPTB. The most affected sites with EPTB were: Lymph nodes (66.5%), pleural cavity (15.6%), abdominal organs (11.1%), neuromeningeal (2.2%), joints (2.2%) and heart (2.2%). Overall, 84.4% of the study participants had a therapeutic success with males responding better 57.9% (p = 0.442). Therapeutic success was better (71.7%) in HIV negative EPTB patients (p = 0.787). CONCLUSION: The prevalence of bacteriologically confirmed EPTB patients treated under program conditions in the littoral region of Cameroon is high with a therapeutic success of 84.4% and the lymph nodes is the most affected site.
Asunto(s)
Infecciones por VIH/epidemiología , Tuberculosis/epidemiología , Adolescente , Adulto , Antituberculosos/uso terapéutico , Camerún/epidemiología , Coinfección/epidemiología , Estudios Transversales , Farmacorresistencia Bacteriana , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular , Prevalencia , Rifampin/uso terapéutico , Factores Sexuales , Resultado del Tratamiento , Tuberculosis/tratamiento farmacológico , Tuberculosis Cardiovascular/tratamiento farmacológico , Tuberculosis Cardiovascular/epidemiología , Tuberculosis del Sistema Nervioso Central/tratamiento farmacológico , Tuberculosis del Sistema Nervioso Central/epidemiología , Tuberculosis Ganglionar/tratamiento farmacológico , Tuberculosis Ganglionar/epidemiología , Tuberculosis Osteoarticular/tratamiento farmacológico , Tuberculosis Osteoarticular/epidemiología , Tuberculosis Pleural/tratamiento farmacológico , Tuberculosis Pleural/epidemiología , Adulto JovenRESUMEN
Tuberculous aortic aneurysms are rare. Localization in the isthmus of the aorta is still exceptional. It often presents as a false aneurysm, which exposes to the risk of rupture, whatever the size of the aneurysm, and worsens the prognosis. The treatment of reference relies on surgery in association with antituberculosis treatment. The endovascular approach with stent grafts can be an alternative as presented in this case report, in which traditional surgery was judged to be at risk in a nonagenarian patient.
Asunto(s)
Aneurisma Falso/cirugía , Aneurisma Infectado/cirugía , Aneurisma de la Aorta/cirugía , Implantación de Prótesis Vascular/instrumentación , Prótesis Vascular , Procedimientos Endovasculares/instrumentación , Stents , Tuberculosis Cardiovascular/cirugía , Anciano de 80 o más Años , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/fisiopatología , Aneurisma Infectado/diagnóstico por imagen , Aneurisma Infectado/microbiología , Antituberculosos/uso terapéutico , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/microbiología , Aortografía/métodos , Angiografía por Tomografía Computarizada , Humanos , Masculino , Resultado del Tratamiento , Tuberculosis Cardiovascular/diagnóstico por imagen , Tuberculosis Cardiovascular/microbiologíaRESUMEN
CASE PRESENTATION: A 38-year-old man of Indian origin, who migrated to Greece 13 years prior to presentation, was admitted to our hospital with a 2-month history of nonprogressive, intermittent (mostly evening), low-grade (up to 38.5°C) fever, accompanied by night sweats, dry cough, mild dyspnea on exertion (modified Medical Research Council Dyspnea Scale grade 1), anorexia, fatigue, and weight loss of 10 kg. He also experienced continuous palpitations, which were regular, not associated with chest pain or dizziness, and aggravated on exertion. He had not taken any medication for his condition, except for antipyretic agents, nor had he sought medical advice. He was a nonsmoker, had a history of past alcohol dependence, and had been hospitalized twice for acute pancreatitis due to hypertriglyceridemia. He had also been diagnosed with diabetes mellitus, presumably poorly controlled because he mentioned not taking any medication or having regular follow-up.