Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old Acquaintance
Introduction: Mycobacterium tuberculosis (MT) is a rare cause of mycotic aneurysms. Diagnosis and management of tuberculous arterial infection is challenging. A case of a patient diagnosed and successfully treated for an aortic pseudoaneurysm caused by MT infection is reported. Report: An 83 year ol...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | EJVES Vascular Forum |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666688X22000090 |
| _version_ | 1798030920773533696 |
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| author | Nuno Henriques Coelho Victor Martins Alexandra Canedo |
| author_facet | Nuno Henriques Coelho Victor Martins Alexandra Canedo |
| author_sort | Nuno Henriques Coelho |
| collection | DOAJ |
| description | Introduction: Mycobacterium tuberculosis (MT) is a rare cause of mycotic aneurysms. Diagnosis and management of tuberculous arterial infection is challenging. A case of a patient diagnosed and successfully treated for an aortic pseudoaneurysm caused by MT infection is reported. Report: An 83 year old man was admitted with recurrent back pain over five months associated with constitutional symptoms. Computed tomography angiography (CTA) revealed a psoas collection associated with terminal aorta and proximal left common iliac artery posterolateral wall ulceration. Percutaneous drainage was performed and both the acid fast bacillus test and the molecular test for MT DNA were positive. The patient started on anti-tuberculous treatment, showing an excellent response. Three month CTA revealed arterial ulceration stability. However, the six month CTA revealed evolution to an asymptomatic 40 mm pseudoaneurysm. He was submitted to open repair with an aorto-bi-iliac interposition silver acetate/triclosan collagen coated polyester graft. The post-operative course was uneventful. Discussion: Increased awareness and pursuit of an histological and microbiological diagnosis along with close surveillance allow anticipation of complications that can develop without any warning symptoms, as reported in this case. Agent identification and a combination of prolonged anti-tuberculous drug therapy with extensive excision of the infected field along with aortic reconstruction contributed to a good outcome. |
| first_indexed | 2024-04-11T19:48:57Z |
| format | Article |
| id | doaj.art-259754a02e3c4d61adf58b00e536f790 |
| institution | Directory Open Access Journal |
| issn | 2666-688X |
| language | English |
| last_indexed | 2024-04-11T19:48:57Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EJVES Vascular Forum |
| spelling | doaj.art-259754a02e3c4d61adf58b00e536f7902022-12-22T04:06:22ZengElsevierEJVES Vascular Forum2666-688X2022-01-01561619Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old AcquaintanceNuno Henriques Coelho0Victor Martins1Alexandra Canedo2Corresponding author. Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal.; Department of Angiology and Vascular Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PortugalDepartment of Angiology and Vascular Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PortugalDepartment of Angiology and Vascular Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PortugalIntroduction: Mycobacterium tuberculosis (MT) is a rare cause of mycotic aneurysms. Diagnosis and management of tuberculous arterial infection is challenging. A case of a patient diagnosed and successfully treated for an aortic pseudoaneurysm caused by MT infection is reported. Report: An 83 year old man was admitted with recurrent back pain over five months associated with constitutional symptoms. Computed tomography angiography (CTA) revealed a psoas collection associated with terminal aorta and proximal left common iliac artery posterolateral wall ulceration. Percutaneous drainage was performed and both the acid fast bacillus test and the molecular test for MT DNA were positive. The patient started on anti-tuberculous treatment, showing an excellent response. Three month CTA revealed arterial ulceration stability. However, the six month CTA revealed evolution to an asymptomatic 40 mm pseudoaneurysm. He was submitted to open repair with an aorto-bi-iliac interposition silver acetate/triclosan collagen coated polyester graft. The post-operative course was uneventful. Discussion: Increased awareness and pursuit of an histological and microbiological diagnosis along with close surveillance allow anticipation of complications that can develop without any warning symptoms, as reported in this case. Agent identification and a combination of prolonged anti-tuberculous drug therapy with extensive excision of the infected field along with aortic reconstruction contributed to a good outcome.http://www.sciencedirect.com/science/article/pii/S2666688X22000090Mycotic aneurysmMycobacterium tuberculosisOpen repair |
| spellingShingle | Nuno Henriques Coelho Victor Martins Alexandra Canedo Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old Acquaintance EJVES Vascular Forum Mycotic aneurysm Mycobacterium tuberculosis Open repair |
| title | Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old Acquaintance |
| title_full | Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old Acquaintance |
| title_fullStr | Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old Acquaintance |
| title_full_unstemmed | Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old Acquaintance |
| title_short | Tuberculous Aortic Pseudoaneurysm: An Unexpected Encounter with an Old Acquaintance |
| title_sort | tuberculous aortic pseudoaneurysm an unexpected encounter with an old acquaintance |
| topic | Mycotic aneurysm Mycobacterium tuberculosis Open repair |
| url | http://www.sciencedirect.com/science/article/pii/S2666688X22000090 |
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