Disseminated tuberculosis in an immunocompetent patient.
Miliary tuberculosis refers to the clinical disease resulting from the hematogenous dissemination of Mycobacterium tuberculosis. A tuberculous aneurysm of the aorta is exceedingly rare. Contiguous tuberculosis in the form of lymphadenitis is generally responsible for the aortic involvement. We report a case of tuberculous mycotic aneurysm in patient with miliary disease, not affected by a cellular immunodeficiency and with no other common risk factor for infection. He received anti-tubercular therapy and endovascular stenting before the identification of Mycobacterium tuberculosis in lung, lymph nodes, and gastric lavage. The clinician should be aware that a mycotic abdominal aortic aneurysm could be caused by M. tuberculosis, even if microbiological confirmation is lacking or is negative, especially if a contiguous focus of tubercular infection is detected.
Internal Medicine Division Cattinara Hospital, Strada di Fiume 447, Trieste, Italy. filippome@libero.it
Filippo
F
Mearelli
Ismet
I
Burekovic
Michela
M
Zanetti
Nicola
N
Altamura
Giansante
G
Carlo
Gianni
G
Biolo
Stefano
S
Cernic
Chiara
C
Casarsa
D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed; D014391:Tuberculosis, Miliary / Q000150:complications / Q000175:diagnosis*
Miliary tuberculosis; Mycotic abdominal aneurysm; Tubercular abdominal aortic aneurysm