Probable intracardiac tuberculoma in an HIV positive woman

Abstract

Objective-To assess the long term prognostic significance of aortic valve ring abscess in patients with aortic endocarditis. Patients-A consecutive series of 75 patients who had surgery for aortic infective endocarditis between 1981 and 1989; 35 had aortic ring abscesses (group 1) and 40 did not (group 2). Mean age did not diVer between the two groups. Prosthetic valve endocarditis was present in 17% of group 1 and 5% of group 2. Pneumococcal or haemolytic streptococcal endocarditis was more common in patients with native valve endocarditis who had aortic ring abscesses (20% v 5%). Design-Cohort analysis. Results-In-hospital mortality (11.4% v 7.5%) and 10 year survival (56% v 66%) were not significantly diVerent between groups 1 and 2. In patients with native valve endocarditis, 10 year survival was 62% and 66%, respectively for patients with or without ring abscess, and 10 year reintervention-free survival was 38% v 58% (p = 0.11). In these patients, the presence of an intercurrent illness, severe congestive heart failure before surgery, and use of valved conduits for surgical treatment were predictors of poorer long term survival. At follow up residual aortic regurgitation was documented in 72% of patients in group 1 and 26% in group 2 (p < 0.01). Conclusions-Aortic valve ring abscess is not an independent marker of poor long term outcome in patients with infective endocarditis. However, as residual aortic regurgitation appears frequent at follow up, specific surgical techniques should be considered in patients with paravalvar abscesses.

Case report: Myocardial tuberculosis-MRI

“…Regression of disease has been reported in response to antituberculous therapy[81011] and this was also seen in our case. In cases where the diagnosis is still doubtful, surgical resection with biopsy may be required.…”

“…In our case, the T2 hypointense character of the diffuse myocardial involvement, including the nodular lesion at the right atrial inlet, and the extracardiac findings of necrotic mediastinal nodes, led us to suspect the possibility of tuberculosis. Regression of disease has been reported in response to antituberculous therapy[ 8 10 11 ] and this was also seen in our case. In cases where the diagnosis is still doubtful, surgical resection with biopsy may be required.…”

Infección del miocardio por Mycobacterium tuberculosis: una localización infrecuente de una infección antigua

“…El tratamiento antituberculoso ha sido exitoso en la mayoría de los pacientes, demostrando regresión de las lesiones 6,13,14 . La duración recomendada para la tuberculosis extrapulmonar en Colombia es de seis meses 15 .…”