ABSTRACT
Tuberculous aortitis [TA] is a rare entity that is invariably indicative of disseminated tuberculosis. TA is associated with aneurysm formation in about half of cases. Another possible complication is perforation of adjacent structures [1-7]. Both abdominal and thoracic aorta are involved with equal frequency.[7-9] Fatal outcomes are frequently reported even after antituberculosis chemotherapy and surgical intervention. We present a case of tuberculous aortic aneurysm [TBAA] that underwent surgical resection and graft replacement in the bed of the infected aorta. Following an apparently successful chemotherapy, the patient died suddenly. We postulate that reactivation of the un-eradicated bacilli precipitated graft failure. Similar cases in the literature are reviewed. We propose lifelong suppressive therapy with antituberculosis agents to prevent such a catastrophic event
Subject(s)
Humans , Male , Aortitis/complications , Tuberculosis, Cardiovascular/pathology , Tuberculosis, Cardiovascular/complications , Aortic Rupture , Tomography, X-Ray Computed , EmergenciesABSTRACT
O acometimento cardíaco na tuberculose é pouco freqüente devido a uma provável resistência natural do miocárdio a infecçäo pelo Mycobacterium tuberculosis. Säo descritas quatro formas de doença no coraçäo: nodular, difusa infiltrativa e miocardite intesticial inespecífica. As vias de contaminaçäo do miocárdio säo a disseminaçäo hematogênica, a drenagem linfática retrógrada a partir de linfonodos mediastinais contaminados e a infecçäo por contiguidade direta com o pericárdio. A ausência de sintomatologia clínica específica e a dificuldade na identificaçäo de bacilos álcool-resistentes tornam dificil o diagnóstico clínico, contribuindo para a evoluçäo desfavorável na maioria dos casos. Os autores apresentam um caso de tuberculose do miocárdio com acometimento valvar, em doente jovem do sexo feminino tratada cirurgicamente e atualmente no sexto mês de acompanhamento