Sudden death related to tuberculous myocarditis: An autopsy case report

Tuberculous myocarditis is a rare manifestation of disseminated tuberculosis that is often misdiagnosed. It may present with non-specific symptoms, or alternatively remain clinically silent, making diagnosis particularly challenging. We present in this paper a case report of a 49-year-old man with a medical history of diabetes, untreated hypertension, and dyslipidemia was found dead in his home. There was no specific symptom before death. A medico-legal autopsy was requested to determine the cause of death. At the internal examination, there were bilateral yellow-citrine pleural effusion, pulmonary edema with congestion, whitish areas in the left ventricular myocardium. Histopathological analysis showed granulomatous myocarditis associated with interstitial granulomatous pneumonitis suggestive of miliary tuberculosis. The cause of death was attributed to acute heart failure related to undiagnosed tuberculous myocarditis.