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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Triple valve endocarditis by mycobacterium tuberculosis: a case report.
Quratulain Shaikh1, Faisal Mahmood
1Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan. quratulain.shaikh@aku.edu
BMC Infectious Diseases
|September 28, 2012
Summary
Tuberculosis can cause rare, culture-negative infective endocarditis, even in immunocompetent individuals. This case highlights Mycobacterium tuberculosis as a cause of triple valve endocarditis, emphasizing its consideration in endemic regions.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Tuberculous granulomas are found in the heart at autopsy, primarily in the myocardium and endocardium.
- Mycobacterium tuberculosis valvular endocarditis is exceptionally rare, with most cases identified in autopsy studies.
Observation:
- A 17-year-old immunocompetent female presented with fever, malaise, foot gangrene, and left hemiparesis.
- Infective endocarditis involving the aortic, mitral, and tricuspid valves was diagnosed, with a co-occurring right middle cerebral artery stroke.
- Surgical intervention included dual valve replacement and tricuspid repair; vegetations showed granulomatous inflammation, but cultures were negative.
Findings:
- This is the first reported case of triple valve endocarditis caused by Mycobacterium tuberculosis in an immunocompetent host.
- The involvement of the right heart is notable, typically associated with intravenous drug abuse.
Implications:
- Tuberculosis should be considered in the differential diagnosis of culture-negative endocarditis, particularly in endemic areas like Pakistan.
- This case underscores the importance of considering Mycobacterium tuberculosis in immunocompetent patients with severe infective endocarditis.
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