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Ascending aortic aneurysm caused by Mycobacterium tuberculosis

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 Mycoba...

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Autores principales: Pathirana, Upul, Kularatne, Saman, Karunaratne, Suneth, Ranasinghe, Gamini, Fernando, Janakie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638108/
https://www.ncbi.nlm.nih.gov/pubmed/26553119
http://dx.doi.org/10.1186/s13104-015-1667-x
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author Pathirana, Upul
Kularatne, Saman
Karunaratne, Suneth
Ranasinghe, Gamini
Fernando, Janakie
author_facet Pathirana, Upul
Kularatne, Saman
Karunaratne, Suneth
Ranasinghe, Gamini
Fernando, Janakie
author_sort Pathirana, Upul
collection PubMed
description 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.
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spelling pubmed-46381082015-11-10 Ascending aortic aneurysm caused by Mycobacterium tuberculosis Pathirana, Upul Kularatne, Saman Karunaratne, Suneth Ranasinghe, Gamini Fernando, Janakie BMC Res Notes Case Report 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. BioMed Central 2015-11-09 /pmc/articles/PMC4638108/ /pubmed/26553119 http://dx.doi.org/10.1186/s13104-015-1667-x Text en © Pathirana et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Pathirana, Upul
Kularatne, Saman
Karunaratne, Suneth
Ranasinghe, Gamini
Fernando, Janakie
Ascending aortic aneurysm caused by Mycobacterium tuberculosis
title Ascending aortic aneurysm caused by Mycobacterium tuberculosis
title_full Ascending aortic aneurysm caused by Mycobacterium tuberculosis
title_fullStr Ascending aortic aneurysm caused by Mycobacterium tuberculosis
title_full_unstemmed Ascending aortic aneurysm caused by Mycobacterium tuberculosis
title_short Ascending aortic aneurysm caused by Mycobacterium tuberculosis
title_sort ascending aortic aneurysm caused by mycobacterium tuberculosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638108/
https://www.ncbi.nlm.nih.gov/pubmed/26553119
http://dx.doi.org/10.1186/s13104-015-1667-x
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