Tuberculosis pleural y endocarditis como complicaciones de origen multifactorial en granulomatosis con poliangítis. Reporte de caso clínico / Pleural tuberculosis and endocarditis as complications of multifactorial origin in granulomatosis with polyangiitis: Clinical case report

Se presenta el caso de femenino de 36 años con antecedentes de granulomatosis con poliangítis; enfermedad renal crónica e hipertensión arterial sistémica. Debutó con disnea, debilidad y hemoptisis, se sospechó en neumonía atípica, descartándose, persistiendo con taquipnea, taquicardia, dolor torácico. Se inició protocolo para tuberculosis pulmonar con muestras de esputo negativas, hemocultivo positivo para S. haemolyticus, tomografía de tórax con neumotórax izquierdo y derrame pleural ipsilateral, se obtuvo líquido pleural tipo exudado, tinción ácido alcohol-resistente y reacción en cadena de la polimerasa (PCR) para M. tuberculosis negativas; se realizó ecocardiograma de rastreo por soplo de nueva aparición, reportando vegetación valvular, concluyendo diagnóstico de tuberculosis pleural y endocarditis como complicaciones de origen multifactorial asociado a inmunosupresión en granulomatosis con poliangítis.(AU)

We present the case of a 36-year-old woman with a history of granulomatosis with polyangiitis, chronic kidney disease, and systemic arterial hypertension. Debut with dyspnea, weakness, and hemoptysis, she was suspected in atypical pneumonia, discarded, persisting with tachypnea, tachycardia, and chest pain. The protocol for pulmonary tuberculosis was started with negative sputum samples, positive blood culture for Staphylococcus haemolyticus, chest tomography with left pneumothorax and ipsilateral pleural effusion, exudate-type pleural fluid was obtained, acid-fast staining, negative PCR for Mycobacterium tuberculosis. A follow-up echocardiogram was performed due to a new murmur, reporting valvular vegetation, concluding a diagnosis of pleural tuberculosis and endocarditis as complications of multifactorial origin associated with immunosuppression in granulomatosis with polyangiitis.(AU)

Pleural tuberculosis and endocarditis as complications of multifactorial origin in granulomatosis with polyangiitis: Clinical case report.

We present the case of a 36-year-old woman with a history of granulomatosis with polyangiitis; chronic kidney disease; systemic arterial hypertension. Debut with dyspnea, weakness, and hemoptysis, she was suspected in atypical pneumonia, discarded, persisting with tachypnea, tachycardia, chest pain. The protocol for pulmonary tuberculosis was started with negative sputum samples, positive blood culture for S. haemolyticus, chest tomography with left pneumothorax and ipsilateral pleural effusion, exudate-type pleural fluid was obtained, acid-fast staining, negative PCR for M. tuberculosis; A follow-up echocardiogram was performed due to a new murmur, reporting valvular vegetation, concluding a diagnosis of pleural tuberculosis and endocarditis as complications of multifactorial origin associated with immunosuppression in granulomatosis with polyangiitis.