You are here

Article Text

Article menu
Download PDFPDF
Infectious Diseases
Coexistence of pulmonary thromboembolism and pulmonary tuberculosis: a diagnostic dilemma
  1. Ajay Shanker,
  2. Chandramouli Mandya Thimmaiah,
  3. Nandakishore Baikunje and
  4. Nandu Nair
  1. Pulmonary Medicine, KS Hegde Medical Academy, Deralakkate, Mangaluru, Karnataka, India
  1. Correspondence to Dr Nandu Nair; drnn.official{at}gmail.com

Abstract

A man in his early 50s with previously treated pulmonary tuberculosis (TB) presented with a 3-month history of cough, expectoration and progressive breathlessness, accompanied by significant weight loss. Examination revealed tachycardia, tachypnoea, hypoxaemia and unilateral diminished breath sounds. Investigations showed anaemia, leucocytosis and a homogeneous opacity on the left side of the CXR. ECG and echocardiography suggested pulmonary thromboembolism (PTE). A CT pulmonary angiogram confirmed a chronic embolus and a severely fibrosed left lung. A comprehensive thrombophilia workup yielded normal results and the PTE was attributed to his history of TB. Sputum analysis confirmed reactivated TB, leading to the initiation of antitubercular therapy. The patient improved clinically with plans for a repeat CT pulmonary angiography to assess the need for pulmonary thromboendarterectomy after completing TB treatment. This case highlights the possible association of TB and PTE, its management and why it should be considered as a differential diagnosis in patients with a history of TB presenting with exacerbated breathlessness.

  • Venous thromboembolism
  • TB and other respiratory infections
  • Pulmonary embolism
  • Tuberculosis
  • Tuberculosis

https://doi.org/10.1136/bcr-2023-259049

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • X @nandanbaikunje

    • Contributors AS, NN and CMT were responsible for drafting the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. NB gave final approval of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.