[Myocobacterium tuberculosis endomyocarditis. Apropos of a case in a patient with a mitral valve prosthesis]

A case of lethal cardiac tuberculosis with myocardial and endocardial involvement is reported in a 46 year old man with a Starr-Edwards mitral valve prosthesis inserted two years previously for severe mitral regurgitation, secondary to ruptured chordae of the posterior mitral leaflet. Apart from tuberculous pericarditis, cardiac involvement is extremely rare; it occurs in "tuberculous septicemia" whose characteristic features--tuberculinic anergy, hematological abnormalities especially pancytopenia,--lead to delay in diagnosis, which is usually fatal. The case presented is an example.