Sudden death due to myocardial tuberculosis.

Wallis, P. J. W.; Branfoot, A.C.; Emerson, Peter A.

doi:10.1136/thx.39.2.155

Cited by 44 publications

(33 citation statements)

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“…The earliest report of myocardial TB was in 1664 by Maurocordat and second report in 1761 by Morgagni [4]. The myocardium can be affected either by direct extension or by retrograde lymphatic drainage from mediastinal nodes; direct spread from tuberculous pericarditis can also occur [5]. Moreover, during the hematogenous phase of dissemination of primary TB, any and every tissue and organ in the body is liable to seeding by mycobacteria and consequent pathological changes.…”

Section: Resultsmentioning

confidence: 99%

“…Myocardial TB can manifest in various forms. Rhythm disturbances include supraventricular arrhythmias [3,6], ventricular arrhythmias [9] or varying degrees of conduction blocks [10], and sudden cardiac death is also described [5,11]. Right ventricular outflow tract obstruction [3,12,13], ventricular aneurysm [4,13], ventricular pseudoaneurysm [14], aortic insufficiency [15], coronary arteritis [10,13], or congestive heart failure [6,16,17] have also been described in literature.…”

Section: Resultsmentioning

confidence: 99%

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Tuberculous dilated cardiomyopathy: an under-recognized entity?

et al. 2005

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Tuberculous dilated cardiomyopathy: an under-recognized entity?

et al. 2005

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“…Cardiovascular complications and sudden cardiac death have been described in miliary TB. 7 Almost all reported cases were caused by myocardial infiltration or tuberculous myocarditis. It affects patients who are generally asymptomatic and lead normal lives.…”

Section: Discussionmentioning

confidence: 99%

Miliary Tuberculosis as a Cause of Sudden Death in a Patient Misdiagnosed With Depression

Salem¹,

Mesrati²,

Hadhri³

et al. 2016

Infect Dis Clin Pract

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Introduction Today, miliary spread remains one of the world's most lethal infectious diseases. Despite the availability of effective treatment for most cases, it is still a cause of death in our environment. Some cases of active tuberculosis (TB) are not identified until the patient is dead and an autopsy has been performed. We report an autopsy case of miliary TB and discuss the mechanism of death. Case Report N.M. is a 24-year-old woman without any relevant personal medical or family history. She was admitted with fever of 40 days' duration. The fever was irregular, higher at nights, and associated with headache and anorexia. The patient did not give any history of coughing, hemoptysis, sore throat, joint pains, skin rash, abdominal pain, or rheumatic heart disease. The examination and the radiological investigations did not show any abnormalities. The patient was symptomatically medicated and allowed to return home. After 1 week, she was discovered dead in her bed. A forensic autopsy was requested. At necropsy, the lungs, liver, spleen, and kidneys were macroscopically palish, heterogeneous, and dotted with myriad of small seeds (1–2 mm). Mesentery was the seat of a large firm mass, adhering to the intestinal walls and the pancreas. The diagnosis of miliary TB was confirmed by histological examination. The toxicological screening was negative. Conclusions Our case highlights a rare but important complication of TB, which is “TB-related sudden death.” There is a need for more awareness of the disease, especially in the light of recent reports showing a growing incidence of extrapulmonary TB.

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“…Reasons for relative sparing of the myocardium include reference to the statement by Raviart regarding the protective effect of lactic acid produced by muscular activity of the myocardium [3,8]. According to Wallis et al, TB spreads to the myocardium by one of three methods: direct extension, retrograde spread via lymphatics from the mediastinal lymph nodes or by hematogenous route (from miliary disease) [11]. In 1935 Horn and Shaphir described 3 histological types of myocardial TB: a diffuse infiltrative type with numerous lymphocytes and giant cells, a miliary type due to hematogenous spread and lastly a nodular type (tuberculoma) with a central area of caseous necrosis [4].…”

Section: Discussionmentioning

confidence: 99%

“…[15] The lesions seen in sarcoidosis consists of a discrete non-caseous granulomata with numerous lymphocytes at the border. [15,16] [6,11,12,13].…”

Section: Discussionmentioning

confidence: 99%