Aortic Involvement in Disseminated Tuberculosis – Challenges Beyond the Diagnosis

Abstract

Yunzhen Shi,1,* Wanru Guo,2,* Wenjuan Hu,2 Xiaomeng Li,2 Yanwan Shangguan,2 Xuewen Feng,2 Ming Hu,2 Jiafeng Xia,2 Shuting Wang,2 Jingnan Li,1 Li Hong,1 Bin Lu,1 Kaijin Xu2 1Department of Infectious Diseases, Dongyang People’s Hospital, Dongyang, People’s Republic of China; 2State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kaijin Xu, Email [email protected]: Tuberculous aortitis (TA) is a rare disease with a high mortality rate. Aortic pseudoaneurysm is the most common vascular pattern of TA, and isolated arterial wall thickening and arterial stenosis can also be seen in TA. We report two cases of disseminated tuberculosis involving the aorta with clinical improvement after treatment. One patient who had an aortic ulcer and intermural hematoma received anti-tuberculosis along with steroids therapy. The other patient, who developed a tubercular abdominal aortic pseudoaneurysm during anti-tuberculosis therapy, successfully received endovascular stent implantation. Clinicians should be aware that TA should be considered in patients with aortitis and active tuberculosis.Keywords: tuberculosis aortitis, aortic pseudoaneurysm, anti-tuberculosis therapy, steroids, endovascular stent implantation

Keywords

• tuberculosis aortitis
• aortic pseudoaneurysm
• anti-tuberculosis therapy
• steroids
• endovascular stent implantation