BMJ Case Reports 2013; doi:10.1136/bcr-2013-008869

Tuberculosis: still an enigma. Presenting as mycotic aneurysm of aorta

  1. C N Manjunath
  1. Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
  1. Correspondence to Dr Shivakumar Bhairappa, snbhairappa{at}

The term mycotic aneurysm is a misnomer that has nevertheless been generally adopted to describe aneurysms that occur secondary to the infectious destruction of the arterial wall. Mycotic aneurysm secondary to tuberculous infection of the aorta is a rare and life-threatening disease. Both abdominal and thoracic aorta are involved with equal frequency.1 Tuberculous aneurysms are usually a consequence of transmural perforation caused by direct extension to the vessel from a contiguous focus, often lymphadenitis, but also pulmonary,2 digestive or vertebral. Other mechanisms implicated are haematogenous contamination through the vasa vasorum,3 or an autoimmune response to tuberculosis.

Clinical features are highly …

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