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Endocardial tuberculosis
Pranav Kandachar1, Devajyoti Guin2, Suravi Mohanty3
1Department of Cardiothoracic Surgery, St. John's Medical College Hospital, Bangalore, India.
The Annals of Thoracic Surgery
|October 6, 2014
Summary
A rare case of tuberculosis affecting a left atrial mass in a patient with stroke is presented. Surgical removal of the mass resolved the fever, confirming tuberculosis as a cause of intracardiac lesions.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Tuberculosis (TB) is a significant global health issue.
- Intracardiac masses can present with diverse clinical manifestations.
- Differential diagnosis of left atrial masses typically includes thrombus, tumors, and endocarditis.
Observation:
- A 30-year-old male with a history of stroke presented with persistent fever and a left atrial mass.
- Radiological diagnosis suggested miliary pulmonary tuberculosis.
- Fever persisted despite two months of antitubercular treatment.
Findings:
- Surgical excision of the left atrial mass led to complete resolution of fever.
- Histopathological examination and Ziehl-Neelsen staining of the mass revealed Acid Fast Bacilli (AFB).
- Visualization of AFB from an intracardiac lesion via ZN staining is a novel finding.
Implications:
- This case highlights tuberculosis as a potential, albeit rare, cause of intracardiac masses.
- Tuberculosis should be considered in the differential diagnosis of left atrial masses, especially in endemic areas or in patients with risk factors.
- Early diagnosis and appropriate treatment are crucial for managing intracardiac tuberculosis to prevent complications.
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