Coexistence of pulmonary thromboembolism and pulmonary tuberculosis: a diagnostic dilemma.

Autor: Shanker A; Pulmonary Medicine, KS Hegde Medical Academy, Deralakkate, Mangaluru, Karnataka, India., Mandya Thimmaiah C; Pulmonary Medicine, KS Hegde Medical Academy, Deralakkate, Mangaluru, Karnataka, India., Baikunje N; Pulmonary Medicine, KS Hegde Medical Academy, Deralakkate, Mangaluru, Karnataka, India., Nair N; Pulmonary Medicine, KS Hegde Medical Academy, Deralakkate, Mangaluru, Karnataka, India drnn.official@gmail.com.
Jazyk: angličtina
Zdroj: BMJ case reports [BMJ Case Rep] 2024 Sep 12; Vol. 17 (9). Date of Electronic Publication: 2024 Sep 12.
DOI: 10.1136/bcr-2023-259049
Abstrakt: A man in his early 50s with previously treated pulmonary tuberculosis (TB) presented with a 3-month history of cough, expectoration and progressive breathlessness, accompanied by significant weight loss. Examination revealed tachycardia, tachypnoea, hypoxaemia and unilateral diminished breath sounds. Investigations showed anaemia, leucocytosis and a homogeneous opacity on the left side of the CXR. ECG and echocardiography suggested pulmonary thromboembolism (PTE). A CT pulmonary angiogram confirmed a chronic embolus and a severely fibrosed left lung. A comprehensive thrombophilia workup yielded normal results and the PTE was attributed to his history of TB. Sputum analysis confirmed reactivated TB, leading to the initiation of antitubercular therapy. The patient improved clinically with plans for a repeat CT pulmonary angiography to assess the need for pulmonary thromboendarterectomy after completing TB treatment. This case highlights the possible association of TB and PTE, its management and why it should be considered as a differential diagnosis in patients with a history of TB presenting with exacerbated breathlessness.
Competing Interests: Competing interests: None declared.
(© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze: MEDLINE
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