Aortic Involvement in Disseminated Tuberculosis - Challenges Beyond the Diagnosis

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Vascular Surgery

Background:

• Tuberculous aortitis (TA) is a rare vascular complication of tuberculosis (TB).
• It presents with diverse vascular manifestations, including aortic pseudoaneurysms, arterial wall thickening, and stenosis.
• TA carries a high mortality rate if not promptly diagnosed and treated.

Observation:

• This report details two cases of disseminated tuberculosis affecting the aorta.
• Case 1: A patient with an aortic ulcer and intramural hematoma treated with anti-tuberculosis drugs and steroids.
• Case 2: A patient who developed a tubercular abdominal aortic pseudoaneurysm during anti-tuberculosis therapy, successfully managed with endovascular stent implantation.

Findings:

• Both patients demonstrated clinical improvement following appropriate management strategies.
• Successful treatment involved a combination of anti-tuberculosis therapy and, in one case, endovascular intervention.
• These cases highlight the varied presentations and effective management options for TA.

Implications:

• Clinicians must consider tuberculous aortitis in patients presenting with aortitis, especially those with active tuberculosis.
• Prompt recognition and tailored treatment are essential for improving outcomes in TA.
• Further research into the optimal management of TA is warranted.