[Apropos of a case of pericardo pleuro-pulmonary tuberculosis].
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Now aneurysmectomy and graft replacement is the most popular surgical method of aortic aneurysm, but there are many opinions about surgical methods and assist circulation for emergency operation of ruptured aortic aneurysm. We experienced the case of ruptured thoracoabdominal aortic aneurysm with tuberculosis, and rescued the patient by extra-anatomic bypass (EAB). A 60-year-old woman, who had been treated with tuberculosis for about 40 years, was operated on for cold abscess of her left psoas muscle by other orthopedic surgeons. At that time, massive bleeding happened, and she was transferred to us under diagnosis of ruptured thoracoabdominal aortic aneurysm. EAB, as emergency operation, was done because we considered it was dirty and dangerous to replace the prosthesis beside the abscess. The postoperative course was almost uneventful except the evidence of Gaffky's first stage. We considered EAB was an useful method for emergency cases and some infectious aortic aneurysms.
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Mycotic aneurysm secondary to Mycobacterium tuberculosis is extremely unusual. We describe a 28-year-old female patient with tuberculosis who developed synchronous mycotic aneurysms of the abdominal aorta and the innominate artery. The pathogenesis, diagnosis, and treatment of tuberculous mycotic aneurysm is reviewed.
Three cases of tuberculosis of serous membranes (1 pleuritis, 1 pericarditis, 1 meningitis) are reported in the absence of detected superinfection, all of them characterized by a purulent effusion. Even in tuberculosis endemic zones, the purulent character of the puncture liquid of tuberculotic serositis appears to be rare or exceptional. Tuberculosis has to be systematically considered among the causes of pleuritis, pericarditis or purulent meningitis when any current investigations are negative.
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Coronary artery disease is overwhelmingly atherosclerotic in nature, but inflammatory disease of the coronary arteries can be just as life-threatening a cause of ischemic heart disease in all age groups. Coronary vasculitis is not short in variety; as a clinicopathologic entity it spans the entire spectrum of systemic vasculitides. Coronary vasculitis is most closely associated with the polyarteritis group of necrotizing angiitis, vasculitis of collagen-vascular disease, and granulomatous giant cell arteritis. This article provides an overview of coronary vasculitis as an independent entity as well as a manifestation of systemic vasculitis, both the common and the uncommon varieties.
Myocardial tuberculosis (TB) was encountered in 19 patients (0.14%) at autopsy over a 27-year period. Eight patients had miliary lesions, and 11 had nodular lesions. Myocardial TB was diagnosed ante mortem in only one patient. Three patients developed left ventricular aneurysms. Tuberculous lesions were most commonly observed in the ventricles. Nodular tuberculous lesions produced no significant cardiac dysfunction, and the severe systemic symptoms of patients with miliary TB overshadowed the effects of cardiac miliary TB. Two additional patients with disseminated TB showed a focal lymphocytic myocarditis unassociated with diagnostic tuberculous lesions in the heart. This myocarditis differed histologically from the diffuse myocarditis described in the older literature.
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