A case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis

Saboe, Aninka; Sakasasmita, Sylvie; Hartantri, Yovita; Maryani, Euis; Hadar, Abdul Kadir; Sudjud, Reza Widianto; Azis, Afiati; Chaidir, Lidya; Nugraha, Harry Galuh; Hasan, Melawati; Cool, Charlotte Johanna; Alisjahbana, Bachti; Akbar, Mohammad Rizki

doi:10.1016/j.idcr.2021.e01313

Cited by 3 publications

(2 citation statements)

References 14 publications

(9 reference statements)

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“…Diagnosing cardiac TB poses numerous challenges given that most individuals infected with TB are unsuspected, without any significant symptoms, and are diagnosed postmortem (5). The direct detection of mycobacterium or its products is the gold standard for identifying TB as the cause of endocarditis (6). However, this approach can be difficult due to the non-uniform distribution of bacteria and the challenge of accessing the site.…”

Section: Discussionmentioning

confidence: 99%

Mitral Valve Mass in a Patient with Positive Tuberculosis Wound Pathology: Successful Medical Management and Regression of Cardiac Mass

Akiash,

Heidari,

Moradi

et al. 2024

Shiraz E-Med J

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Introduction: Tuberculosis (TB) is a chronic granulomatous disease, ranking as the second cause of death by infectious agents in 2021. Tuberculosis affects millions worldwide, with valvular TB being a rare manifestation, accounting for less than 1% of extrapulmonary TB cases. Valvular TB is often diagnosed through imaging and laboratory evaluations, and the treatment involves prolonged antibiotic therapy and might require surgical intervention for damaged cardiac valves. Case Presentation: A 60-year-old female patient with diabetes mellitus and rheumatoid arthritis was referred for a cardiac assessment prior to hand wound debridement surgery. Transthoracic echocardiography (TTE) revealed a mass on the mitral valve, and subsequent transesophageal echocardiography (TEE) confirmed a large, mobile mass with abscess-like density. A blood culture study was negative for infective endocarditis, and a biopsy of the wound revealed necrotizing granuloma positive for Mycobacterium tuberculosis. Anti-TB medication was initiated, resulting in a significant improvement in the valve mass. No cardiac complications were reported during the follow-up. Conclusions: In suspected cardiac TB patients with a high risk of surgery or patients reluctant to undergo an operation, quadruple chemotherapy can serve as a diagnostic and therapeutic tool.

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Section: Discussionmentioning

confidence: 99%

Mitral Valve Mass in a Patient with Positive Tuberculosis Wound Pathology: Successful Medical Management and Regression of Cardiac Mass

Akiash,

Heidari,

Moradi

et al. 2024

Shiraz E-Med J

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“…6 There are only a few studies evaluating qPCR for OATB. Even in those studies, the diagnosis of OATB was limited to either a single case or a single gene target, 16,17 or studies where OATB specimens formed a small chunk of the total EPTB specimens. 6 Our observation on performance of different gene targets is in contrast to a recent study by Antonello et al, 18 wherein in-house droplet-digital PCR (on 89 Italian EPTB specimens including four OATB specimens) reported a sensitivity of 66.2% for rpoB and 98.5% for IS6110.…”

Section: Discussionmentioning

confidence: 99%

Diagnosing osteo‐articular tuberculosis and multidrug resistance using real‐time polymerase chain reaction and high‐resolution melt‐curve analysis

Sharma

et al. 2022

Journal Orthopaedic Research

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The study evaluated real-time quantitative polymerase chain reaction (qPCR) and high-resolution melt-curve analysis (HRM) for simultaneous diagnosis of osteoarticular tuberculosis (OATB) and drug resistance. Two hundred and fifty synovial fluid and pus specimens (20 confirmed OATB by culture, 130 suspected OATB, and 100 controls) processed in the Department of Medical Microbiology, PGIMER were subjected to qPCR using rpoB, MPB64, and IS6110 genes. All OATB positive specimens were subjected to HRM for detecting resistance to rifampicin and isoniazid. qPCR detected 129/150 OATB cases with a sensitivity of 86% (95% for confirmed and 84.6% for suspected OATB cases) and specificity of 100%. rpoB and MPB64 genes had higher sensitivity than IS6110 (86% vs. 74.6%). HRM reported eight multidrug resistant (MDR), two mono-rifampicin, and five mono-isoniazid resistant cases, all were concordant with gene sequencing. qPCR followed by HRM analysis offer a simple, accurate, and rapid platform for simultaneous detection of OATB and MDR.

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Culture-negative tricuspid valve endocarditis in an intravenous drug abuser masquerading as pulmonary tuberculosis in Nepal: a case report

Rajkarnikar

Sharma

Yadav

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Infective endocarditis is an infection of the heart valves or endocardium caused by bacterial, viral, or fungal microorganisms. Blood cultures are used to detect the bacteria causing infective endocarditis, and echocardiography is performed to find the damaged heart valves. In blood culture-negative endocarditis, no endocarditis-causing organisms can be found in blood cultures, and blood cultures using usual laboratory methods remain sterile after inoculation of at least three independent blood samples. Case presentation: A 24-year-old male with a history of polysubstance abuse presented with complaints of fever, cough, and shortness of breath. He had a past history of pulmonary tuberculosis 4 years ago, for which he was treated with antitubercular therapy. High-resolution computed tomography of the chest revealed multiple cavitary lesions and consolidative areas in the bilateral lungs. Based on these findings, a provisional diagnosis of reactivation of pulmonary tuberculosis was considered, and antitubercular therapy was started. Due to his deteriorating condition, he was readmitted and evaluated. Bronchoalveolar lavage was done and sent for culture and sensitivity testing, which showed the presence of Staphylococcus aureus, and treatment was started accordingly. Despite continuing intravenous antibiotics for 5 days, the patient was not improving. Three sets of samples were withdrawn for blood culture and sensitivity testing, which came out to be negative. Transthoracic echocardiography was done, which revealed vegetation in the tricuspid valve. The patient was diagnosed with culture-negative tricuspid valve endocarditis based on the clinical criteria. Discussion: Blood culture-negative endocarditis is difficult to diagnose and presents challenges. When faced with a diagnosis like culture-negative endocarditis in the context of a condition that can appear very similar, like tuberculosis, a broad differential diagnostic approach is important. Conclusion: Intravenous drug use is the main cause of right-sided valvular infective endocarditis. Endocarditis should be considered in intravenous drug users even in the absence of positive blood cultures. An appropriate antibiotic regimen and long-term follow-up with a multidisciplinary team are necessary for a good outcome.

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A case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis

Cited by 3 publications

References 14 publications

Mitral Valve Mass in a Patient with Positive Tuberculosis Wound Pathology: Successful Medical Management and Regression of Cardiac Mass

Mitral Valve Mass in a Patient with Positive Tuberculosis Wound Pathology: Successful Medical Management and Regression of Cardiac Mass

Diagnosing osteo‐articular tuberculosis and multidrug resistance using real‐time polymerase chain reaction and high‐resolution melt‐curve analysis

Culture-negative tricuspid valve endocarditis in an intravenous drug abuser masquerading as pulmonary tuberculosis in Nepal: a case report

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