Journal List > Tuberc Respir Dis > v.64(4) > 1001220

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Lee, Cho, Yoon, Lee, Lee, Yoo, Lee, and Kim: A Case of Tuberculosis Presented with Pseudoaneurysm of the Aorta and Acute Respiratory Distress Syndrome
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(4): 298-302.

Published online: 30 April 2008

DOI: https://doi.org/10.4046/trd.2008.64.4.298

A Case of Tuberculosis Presented with Pseudoaneurysm of the Aorta and Acute Respiratory Distress Syndrome

Eung-Jun Lee, M.D., Han-Su Cho, M.D., Hyun-Sung Yoon, M.D., Jung-Hyun Lee, M.D., Tae Hoon Lee, M.D., Kwang Ha Yoo, M.D., Kye Young Lee, M.D., Sun Jong Kim, M.D.

Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University, Seoul, Korea.

Address for correspondence: Sun Jong Kim, M.D. Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konkuk University Hospital, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-914, Korea. Phone: 82-2-2030-7523, Fax: 82-2-2030-7748, sjkim@kuh.ac.kr

Received 6 March 2008       Accepted 10 April 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

We experienced a case of tuberculosis presented simultaneously with pseudoaneurysm of the aorta and ARDS. A 63-year-old man was admitted with complaints of fever and right upper quadrant abdominal pain for a week. Chest X-ray on admission showed a normal finding. Sub-diaphragmatic abscess on abdomen CT scan was suspected and serosanguinous fluid was aspirated from the abscess pocket. On day 2, he was getting more dyspneic and chest X-ray revealed extensive bilateral infiltration. Aspirated fluid revealed AFB. Later, follow-up abdomen CT scan revealed a leakage of dye from the aneurysmal sac of the descending aorta which was previously diagnosed as sub-diaphragmatic abscess. An aortic stent was placed, covering the opening into the aneurysm. The sputum also showed positive AFB. The patient was successfully weaned from the ventilator, and discharged with anti-tuberculous medication on day 42. Follow-up abdomen CT scan 6 months later showed that the aneurymal sac was completely disappeared.

Keywords: Tuberculosis, Pseudoaneurysm, ARDS, Stent

Figures and Tables

Figure 1
Initial chest PA shows normal finding on both lung field.
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Figure 2
Abdominal CT scan image shows a low attenuation lesion (arrow), about 6.2 cm in diameter at the level of diaphragmatic crus.
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Figure 3
Chest X-ray taken on hospital day 3 reveals bilateral diffuse infiltration.
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Figure 4
Chest CT image shows diffuse ground glass opacity and consolidation in both lower lobes.
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Figure 5
Abdominal CT reveals a periaortic fluid collection with leakage of dye from the aorta (arrow), suggesting pseudoaneurysm.
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Figure 6
On aortogram, Endovascular stent (arrow) covers the opening of pseudoaneurysm in the supraceliac aorta.
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Figure 7
Follow up abdomen CT scan after 6 months of antituberulosis medication shows the disappearance of the aneurismal sac (arrow).
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