A rare complication of pulmonary tuberculosis: a case report

Kumarihamy, Prabhashini; Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara; Jayalath, Widana Arachchilage Thilak Ananda

doi:10.1186/s13104-015-0990-6

Cited by 11 publications

(6 citation statements)

References 7 publications

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“…Many cases reported with tuberculosis and occurrence of deep venous thrombosis. 1 - 5 Other haematological complications of pulmonary TB were also reported in literature like thrombosis of hepatic, portal, retinal veins etc. 6 - 10 We present a case of pulmonary tuberculosis causing pulmonary vein thrombosis with atrial extension.…”

Section: Introductionmentioning

confidence: 78%

A rare complication of pulmonary tuberculosis - Pulmonary venous thrombosis with atrial extension

Auti

Ranganath

et al. 2017

J Cardiovasc Thorac Res

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Pulmonary tuberculosis (TB) is serious public health problem in India and worldwide. The mortality rate in pulmonary TB is high in those with advanced disease and in presence of complications. It presents with wide variety of complications of which haematological complications are rare. Many cases were reported pulmonary TB associated with deep venous thrombosis, hepatic and portal venous thrombosis, central retinal venous thrombosis and sagittal sinus thrombosis in TB meningitis. We report a rare case of pulmonary TB with pulmonary venous thrombosis and atrial extension. To our best knowledge, this is the first case reported of its kind.

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Section: Introductionmentioning

confidence: 78%

A rare complication of pulmonary tuberculosis - Pulmonary venous thrombosis with atrial extension

Auti

Ranganath

et al. 2017

J Cardiovasc Thorac Res

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“…Several case series have discussed the occurrence of thrombosis in patients with TB [ 10 , 11 ] and in those with HIV [ 12 , 13 ], however, in this case series we demonstrate the challenges encountered when trying to achieve an International Normalized Ratio (INR) within the therapeutic window with warfarin in this population of TB-HIV co-infected patients.…”

Section: Introductionmentioning

confidence: 86%

Challenges in achieving a target international normalized ratio for deep vein thrombosis among HIV-infected patients with tuberculosis: a case series

et al. 2016

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BackgroundTuberculosis (TB) and HIV are among the risk factors for deep vein thrombosis (DVT). There are several challenges in the management of DVT patients with TB-HIV co-infection including drug-drug interactions and non-adherence due to pill burden.MethodsHIV infected patients starting treatment for TB were identified and followed up two weekly. Cases of DVT were diagnosed with Doppler ultrasound and patients were initiated on oral anticoagulation with warfarin and followed up with repeated INR measurements and warfarin dose adjustment.ResultsWe describe 7 cases of TB and HIV-infected patients in Uganda diagnosed with DVT and started on anticoagulation therapy. Their median age was 30 (IQR: 27–39) years and 86 % were male. All patients had co-medication with cotrimoxazole, tenofovir, lamivudine and efavirenz and some were on fluconazole. The therapeutic range of the International Normalization Ratio (INR) was difficult to attain and unpredictable with some patients being under-anticoagulated and others over-anticoagulated. The mean Time in Therapeutic Range (TTR) for patients who had all scheduled INR measurements in the first 12 weeks was 33.3 %. Only one patient among those with all the scheduled INR measurements had achieved a therapeutic INR by 2 weeks. Four out of seven (57 %) of the patients had at least one INR above the therapeutic range which required treatment interruption. None of the patients had major bleeding.ConclusionWe recommend more frequent monitoring and timely dose adjustment of the INR, as well as studies on alternative strategies for the treatment of DVT in TB-HIV co-infected patients.

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“…There are case reports in the literature associating hypercoagulability with Mycobacterium tuberculosis infection: deep vein thrombosis associated with pulmonary TB, peritoneal TB with secondary portal vein thrombosis, and fatal massive pulmonary embolism despite receiving appropriate RIPE therapy and a therapeutic international normalized ratio. 13 - 15 This is the first reported case, to the authors’ knowledge, of death from a pulmonary embolism in a patient with TB-IRIS from disseminated genitourinary TB.…”

Section: Discussionmentioning

confidence: 81%

Fatal Pulmonary Embolism in the Setting of Immune Reconstitution Inflammatory Syndrome Attributed to Ovarian Tuberculosis

Ugalde

Pirela

Presti

et al. 2017

Journal of Investigative Medicine High Impact Case Reports

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In developed countries, tuberculosis remains a health care challenge due to human immunodeficiency virus (HIV) and immigration from endemic regions. The Centers for Disease Control and Prevention reported 9557 new cases in 2015, with extrapulmonary involvement in 20.2% of the cases. We present a 33-year-old woman from Cape Town, South Africa, who developed abdominal pain and fever while working on a cruise ship. She sought medical where she underwent computed tomography of her chest, abdomen, and pelvis with findings suggestive of pulmonary tuberculosis and an 8.9-cm pelvic mass. HIV testing was positive and the patient was started on antiretroviral therapy. Bronchoscopy confirmed the presence of acid-fast bacilli, and she was started on rifampin, isoniazid, pyrazinamide, and ethambutol. She remained persistently febrile, raising suspicion for immune reconstitution inflammatory syndrome. However, despite empiric antibiotics, the patient remained persistently febrile, tachycardic, and on day 10 of admission she went into ventricular fibrillation and expired. Autopsy revealed an occlusive thrombus in the left main pulmonary artery in addition to necrotizing granulomata in multiple organs and bilateral tubo-ovarian abscesses. Postmortem cultures for were positive for Mycobacterium tuberculosis, all consistent with disseminated Mycobacterium tuberculosis. Although previous reports underscore the association between tuberculosis and hypercoagulability, the exact mechanism remains unknown. In this article, we report a case of disseminated tuberculosis complicated by bilateral tubo-ovarian abscesses with fatal pulmonary thrombus formation.

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A rare complication of pulmonary tuberculosis: a case report

Cited by 11 publications

References 7 publications

A rare complication of pulmonary tuberculosis - Pulmonary venous thrombosis with atrial extension

A rare complication of pulmonary tuberculosis - Pulmonary venous thrombosis with atrial extension

Challenges in achieving a target international normalized ratio for deep vein thrombosis among HIV-infected patients with tuberculosis: a case series

Fatal Pulmonary Embolism in the Setting of Immune Reconstitution Inflammatory Syndrome Attributed to Ovarian Tuberculosis

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