title: Miliary tuberculosis in a patient with tuberculous mycotic aneurysm of the abdominal aorta: Case report and review of the literature.
abstract: The combination of miliary tuberculosis and tuberculous mycotic aneurysm has been described in the literature. We present the case of an 84-year-old man who was diagnosed with a mycotic aneurysm of the abdominal aorta and an adjacent soft tissue mass, after a 3- month history of fever. The patient underwent endovascular restoration of the aneurysm and was treated with broad-spectrum antibiotics. One and a half months later the fever relapsed and the chest CT scan revealed findings consistent with miliary tuberculosis and opacities of both upper lobes not present before, while the abdominal CT scan revealed an increase in the size of the para-aortic mass. Tuberculosis was documented by positive culture forM. tuberculosisof bronchial washing and by the CT-guided para-aortic mass biopsy. The patient received anti-TB treatment for 9 months leading to a spectacular improvement of his clinical condition and imaging findings. A review of the literature since 2008 revealed 28 more cases of tuberculous mycotic aneurysm. The treatment and outcome of all cases are described. Mycotic aneurysm of tuberculous etiology remains a reality and has a relatively good prognosis. Although miliary tuberculosis affects mortality even elderly patients may benefit from "aggressive" management and treatment.
authors.affiliation: Respiratory Infections Unit, Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Manika
authors.affiliation: Respiratory Infections Unit, Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Greece.
authors.forename: Christoforos
authors.initials: C
authors.lastname: Efthymiou
authors.affiliation: 1st Internal Medicine Department, Ippokrateion General Hospital, Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Damianidis
authors.affiliation: 1st Internal Medicine Department, Ippokrateion General Hospital, Thessaloniki, Greece.
authors.forename: Elisavet
authors.initials: E
authors.lastname: Zioga
authors.affiliation: Respiratory Infections Unit, Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Papadaki
authors.affiliation: Respiratory Infections Unit, Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Lagoudi
authors.affiliation: Respiratory Infections Unit, Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
keywords: Mycotic aneurysm; Tuberculosis