“Death at the wheel” due to tuberculosis of the myocardium: a case report

Toit-Prinsloo, Lorraine Du; Saayman, Gert

doi:10.1016/j.carpath.2016.03.003

Cited by 10 publications

(17 citation statements)

References 20 publications

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“…The patient in this case was immunocompetent but living in an endemic area with MTB (Saudi Arabia), which is an established risk for NTM infections [2]. The patient’s presentation resembled reported myocardial tuberculoma cases in the clinical, radiological and histopathological pattern [16]. Mycobacterium smegmatis group infection mimicking MTB involving the myocardium has not been documented before in literature, hence, it is an expected complication as almost all NTMs are known to mimic masses and solitary granulomatous nodules [8].…”

Section: Discussionmentioning

confidence: 95%

Mycobacterium smegmatis causing a granulomatous cardiomediastinal mass

Alqurashi

Alsaileek

Aljizeeri

et al. 2019

IDCases

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Non-tuberculous mycobacterial species are uncommon human pathogens. They are divided into slow and rapid growing mycobacteria (RGM) with Mycobacterium smegmatis group as an uncommon pathogen among the RGM. A 19 years old male presented with a 1 month history of dyspnea, orthopnea, unintentional weight loss, palpitation, flu-like symptoms and dry cough. Physical examination revealed tachycardia, distended superficial chest veins with a decrease in breath sounds at the right lower lung with fine crepitations. CT of the chest showed a large anterior mediastinal mass infiltrating the pericardium and three chambers of the myocardium that was confirmed using echocardiography. Despite negative workup for tuberculosis, the patient was treated successfully using first-line anti-TB treatment, which was begun before the tissue culture grew M. smegmatis. To our knowledge, this is the first case in the literature of M. smegmatis infection mimicking cardiomediastinal tuberculoma, and RGM should be suspected in similar presentations with negative TB workup, even in an immunocompetent patient. This is also the first patient to be treated using only first-line anti-tuberculous treatment successfully in the literature.

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Section: Discussionmentioning

confidence: 95%

Mycobacterium smegmatis causing a granulomatous cardiomediastinal mass

Alqurashi

Alsaileek

Aljizeeri

et al. 2019

IDCases

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Section: Discussionmentioning

confidence: 99%

“…Three histological types of myocardial involvement with TB have been described: diffuse infiltrative, miliary and nodular (tuberculoma) [ 1 ]. It was reported that tuberculomas favor certain heart chambers, with the right atrium being the most affected [ 1 ]. Infection spread is thought to occur through three mechanisms: retrograde lymphatic spread, hematogenous spread, and direct spread from a pericardial disease [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…It was reported that tuberculomas favor certain heart chambers, with the right atrium being the most affected [ 1 ]. Infection spread is thought to occur through three mechanisms: retrograde lymphatic spread, hematogenous spread, and direct spread from a pericardial disease [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Tuberculosis (TB) was thought to spare the pancreatic, thyroid, skeletal muscles, and heart [ 1 ], although extrapulmonary TB has been diagnosed in all tissues [ 2 ]. The lactic acid secreted by the cardiac muscle activity may play a protective role [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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A vanishing cardiac mass

Alqurashi¹,

Alsaileek²,

Alenazi³

et al. 2022

Journal of the Saudi Heart Association

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The prevalence of extrapulmonary tuberculosis (TB) is very common in the Middle East; however, myocardial involvement is among the most infrequent manifestations of extrapulmonary TB. We present a young adult who was incidentally found to have a large right atrial tuberculoma, diagnosed by non-invasive cardiac imaging and effectively treated with standard first-line anti-TB treatment, steroids, and anticoagulation. This case is a classical presentation of nodular myocardial involvement of TB, highlighting advantages of advanced imaging, e.g., cardiac magnetic resonance (CMR) and multidisciplinary treatment.

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