[Myocardial tuberculoma: unusual location of tuberculosis: a new observation and review of the literature]. / Tuberculome myocardique: localisation inhabituelle de la tuberculoseà propos d'une nouvelle observation avec une revue de la littérature.

We report the case of a 50-year old patient with a left ventricular tumor whose evolution was marked by impaired general condition and fever. This mass was objectified by echocardiography performed to explore a radiological cardiomegaly. The imaging (MRI) appearance was suggestive of an intra-myocardial tuberculoma Based on our observations, we propose a review of the literature on this unusual location of tuberculosis.

"Death at the wheel" due to tuberculosis of the myocardium: a case report.

According to the World Health Organization, an estimated 9 million people contracted tuberculosis (TB) with approximately 25% of TB cases being from Africa. TB was reported as the number one cause of natural death for the period 2011-2013 in South Africa. The first reported case of myocardial TB was in 1664 by Maurocordat and the first reported case of sudden cardiac death due to TB was made in 1977. We present a case report of myocardial TB in an apparently healthy, 35-year-old male who died suddenly while driving his car. The problems associated with the diagnosis of TB of the myocardium and an overview of the relevant literature is provided.

Pancardiac tuberculosis - a case report.

Tuberculous involvement of the heart though not common has been reported in literature. Pericardium is commonly involved followed by the myocardium. Endocardial involvement is rare. We would like to report a case of a 14-year-old female with florid and extensive involvement of all the layers of the heart by tuberculosis.

Tuberculous pseudoaneurysm of the ascending aorta.

Increase in the incidence of drug resistance and association with HIV has led to a resurgence of tuberculosis. However, tubercular arteritis continues to remain a rare entity with a prelidection for the thoracic aorta. We report a tubercular ascending aortic pseudoaneurysm in a patient already on treatment for disseminated tuberculosis who underwent successful surgical repair and also review literature pertaining to this entity.

Takayasu's or tuberculous arteritis?

Takayasu's arteritis (TA) is a large vessel vasculitis of unknown aetiology characterised by involvement of the aorta and its major branches. Tuberculous arteritis of the aorta is an uncommon condition usually secondary to the dissemination of Mycobacterium tuberculosis infection from the mediastinum and/or lung to the adjacent aorta; this may mimic TA. We report a case of a 23-year-old woman with cutaneous granulomatous vasculitis and saccular aneurysmal dilation of the aorta and large vessels, and highlight the findings shared by TA and tuberculous arteritis.

Death by aortoesophageal fistula due to disseminated tuberculosis: a case study.

Tuberculosis remains a serious public health problem worldwide, especially in Korea. Although tuberculosis is generally considered a non-fatal chronic disease, deaths have occurred. In this case study, a 68-year-old man was admitted to the hospital with dyspepsia, vomiting, and abdominal pain. Nine hours later, he suffered severe hematemesis and died despite cardiopulmonary resuscitation. A medico-legal autopsy was performed and an external examination revealed no external injuries. However, an internal examination revealed an aortoesophageal fistula and a large amount of blood in the stomach. A histologic examination confirmed tuberculous mediastinitis with disseminated tuberculosis involving multiple organs, including the heart, lungs, liver, kidneys, and spleen. Both an aortoesophageal fistula and sudden death due to tuberculosis infection are rare. This paper reports the case of a fatal aortoesophageal fistula associated with disseminated tuberculosis.

Endocardial tuberculosis.

We report a 30-year-old male patient with persistent fever, history of stroke, and a left atrial mass. He was diagnosed as miliary pulmonary tuberculosis radiologically and had fever despite 2 months of antitubercular treatment. The mass was excised and fever resolved. Acid fast bacilli (AFB) were demonstrable on Ziehl Neelsen stain and routine histopathology. To the best of our knowledge, the visualization of AFB from an intracardiac lesion on ZN staining has not been reported earlier and tuberculosis must be considered in the differential diagnosis of left atrial masses.

At-risk brain tissue identified with arterial spin labeling in neurotuberculosis.

A 13-year-old immunocompromised girl developed neurotuberculosis. Arterial spin labeling technique indicated areas of hypoperfusion in the vascular territories of the left posterior cerebral artery and superior cerebellar artery without restricted diffusion, suggesting early tuberculous arteritis. MR angiography confirmed vascular involvement, so adjunctive anticoagulant therapy was initiated. Complete resolution of arterial spin labeling findings was observed 1 month later. This documents early tuberculous vasculopathy revealed by arterial spin labeling in a child with neurotuberculosis. Since there may be a paucity of clinical symptoms in the evolution of arteritis in neurotuberculosis, arterial spin labeling may help indicate early hypoperfusion and alert for modification of treatment before irreversible vascular damage occurs.

A rare disappearing right atrial mass.

Cardiac tuberculosis is rare and usually involves the pericardium. Myocardial tuberculoma is a very rare occurrence and only a few cases have been reported. We describe a rare case of cardiac tuberculoma involving the whole of the lateral right atrial wall, extending from the superior vena cava/right atrial junction up to a tricuspid valve. The initial diagnosis of right atrial myxoma was made based on the echocardiography report and surgical excision was planned. Intraoperatively, the excision of the mass was deferred due to the extensive nature of the disease and a high suspicion of malignancy. Cardiac tuberculoma was confirmed by histopathological examination. The patient made a remarkable recovery with the complete disappearance of the mass after anti-tuberculous treatment, as viewed by a postoperative echocardiography during the follow-up.

Intracardiac left atrial tuberculoma in an eleven-month-old infant: case report.

BACKGROUND: Cardiac tuberculosis is rare and usually manifests as tuberculous pericarditis. Involvement of other part of the heart is unusual and descriptions in the pediatric literature are confined to few case reports regarding mainly myocardial tuberculosis. CASE PRESENTATION: We describe a case of pulmonary miliary tuberculosis associated with intracardiac left atrial tuberculoma in an immunocompetent eleven-month-old infant successfully treated with surgery and antituberculous therapy. CONCLUSION: Although unusual, involvement of endocardium in disseminated tuberculosis should be kept in mind.

PTX3 expression in the heart tissues of patients with myocardial infarction and infectious myocarditis.

INTRODUCTION: The long pentraxin 3 is involved in innate resistance to pathogens, controlling inflammation and extracellular matrix remodeling. Moreover, pentraxin 3 plays a nonredundant role in the regulation of cardiac tissue damage in mice and, recently, it has been proposed as a new candidate marker for acute and chronic heart diseases. However, the actual localization and cellular sources of pentraxin 3 in ischemic and infectious cardiac pathology have not been carefully defined. METHODS: In this study, using immunohistochemistry, we analyzed pentraxin 3 expression in the heart tissues of patients with acute myocardial infarction at different time points after the ischemic event. In addition, we studied the heart tissues of patients with infectious myocarditis (fungi, bacteria, and protozoa) and patients who died of noncardiac events with normal heart histology. RESULTS: In acute myocardial infarction cases, we observed pentraxin 3 localized within and around ischemic lesions. On the contrary, no pentraxin 3 was observed in normal heart areas. In early ischemic lesions, pentraxin 3 was localized primarily in granulocytes; in more advanced acute myocardial infarction, pentraxin 3 positivity was found in the interstitium and in the cytoplasm of macrophages and the endothelium, whereas most granulocytes did not express pentraxin 3, presumably as a consequence of degranulation. In infectious myocarditis, pentraxin 3 was present and localized within and around histological lesions, associated with macrophage, endothelial cell, and, more rarely, myocardiocyte and granulocyte positivities. As observed in acute myocardial infarction patients, no pentraxin 3 staining was found in normal heart areas. CONCLUSIONS: Thus, neutrophils are an early source of pentraxin 3 in acute myocardial infarction and presumably other inflammatory heart disorders. Subsequently, in acute myocardial infarction and infectious myocarditis, pentraxin 3 is produced by macrophages, the endothelium, and, to a lesser extent, myocardiocytes, and localized in the interstitium.

Tubercular granuloma in the myocardium: an autopsy report.

Granulomatous myocarditis is a rare disorder of the myocardium, and is usually associated with various inflammatory and autoimmune conditions. We report granulomatous myocarditis in an apparently healthy 58-year-old Indian man, who developed sudden chest pain and died while being escorted to the hospital. At the autopsy, no gross distinct cardiac lesions were observed. The histopathological sections from the left ventricular apex revealed a granuloma comprising a central area of caseous necrosis surrounded by lymphocytes, and epithelioid, plasma and Langhans giant cells. Myocardial tuberculosis was suspected as the underlying aetiology based on the histological features of the granuloma.

Mycobacterium bovis abdominal aortic and femoral artery aneurysms following intravesical bacillus Calmette-Guérin therapy for bladder cancer.

BACKGROUND: Infectious complications of intravesical bacillus Calmette-Guérin (BCG) therapy are rare, but these have included a handful of cases of mycotic aneurysm. METHODS AND RESULTS: We present the case of a patient with a ruptured abdominal aortic aneurysm and a femoral artery aneurysm who had previously received intravesical BCG therapy for bladder carcinoma. Histopathologic examination of resected tissue revealed numerous acid-fast bacilli, and subsequent mycobacterial culture of blood and resected tissue revealed BCG strain Mycobacterium bovis. CONCLUSIONS: Clinicians should be aware of the possible extravesical complications, albeit rare, of BCG therapy. Therapy should consist of combined medical and surgical management.

Sudden death in tuberculous myocarditis.

Tuberculous myocarditis is one of the rare causes of sudden death. We report a case of 65-year-old female who came with diabetic foot and died suddenly after 2 days of hospital stay. On autopsy, she was found to have tuberculous myocarditis with granulomatous inflammation only in the liver and without pulmonary or mediastinal lymph node involvement. These findings are very unusual in tuberculous myocarditis.

Bicaval obstruction complicating right atrial tuberculoma: the diagnostic value of cardiovascular MR.

Cardiac tuberculosis is rare and usually involves the pericardium. Myocardial tuberculoma is a very rare occurrence and only a few cases were reported. We describe the use of cardiovascular magnetic resonance in the diagnosis of a rare case of cardiac tuberculoma involving the right atrium which was complicated by a bicaval obstruction. The patient made a remarkable improvement with the anti-tuberculous treatment. To our knowledge, this complication has never been reported in relation to cardiac tuberculoma.

Resolution of nodular myocardial tuberculosis demonstrated by contrast-enhanced magnetic resonance imaging.

In sub-Saharan Africa, pericardial tuberculosis is frequently diagnosed in HIV sero-positive patients. Myocardial involvement has only rarely been reported. We present an HIV sero-positive patient in whom both pericardial and myocardial tuberculosis were diagnosed, and highlight the value of cardiac magnetic resonance imaging in the diagnosis and management of this condition.