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CASE REPORT
Unusual presentation of a young man with disseminated tuberculosis and right ventricular mass
  1. Shahrukh Hashmani1,
  2. Fateh Ali Tipoo Sultan1,
  3. Muhammad Qamar Masood2
  1. 1Department of Cardiology, Aga Khan University Hospital, Karachi, Pakistan
  2. 2Department of Endocrinology, Aga Khan University Hospital, Karachi, Pakistan
  1. Correspondence to Dr Shahrukh Hashmani, drshahrukhhashmani{at}gmail.com

Summary

We report a 22-year-old man who presented to the emergency department with worsening shortness of breath and chronic fever for 2 months. Physical examination was unremarkable except for raised jugular venous pressure and palpable liver. Echocardiogram showed a large right ventricular mass causing obstruction at tricuspid valve. A subsequent chest CT scan confirmed the presence of a large mass in the right ventricle. There were multiple enlarged lymph nodes and consolidation in the right upper lobe. Diagnosis of disseminated tuberculosis (TB) was made and later confirmed by histopathology of lymph node biopsy along with positive sputum culture for acid-fast bacilli. Remarkable recovery was observed on antituberculous therapy, with complete disappearance of the cardiac mass on echocardiogram, at 1-year follow-up. Although unusual and rare, myocardial involvement as a large mass should be kept in mind while treating patients with disseminated TB.

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Footnotes

  • Contributors SH did the literature search; gathered history; involved in collection of data, images and videos; drafted the manuscript; analysed and formatted the case. FATS edited the manuscript and involved in critical revision and supervision of the manuscript. MQM is the primary physician who directly involved in care and the final revision of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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