Pulmonary Tuberculosis With Saddle Pulmonary Embolism and Deep Vein Thrombosis: A Rare Case Report

Abstract

Pulmonary tuberculosis is a common endemic disease in developing countries but its thrombogenic tendency is not well-studied and established yet. Pulmonary embolism is rarely reported in Mycobacterium tuberculosis infection. There are reports stating the relation of pulmonary embolism (PE) and deep vein thrombosis (DVT) with a severe infection of tuberculosis but no data is available to establish a mutual association between pulmonary tuberculosis and pulmonary thromboembolism. Herein, we report the case of a 51-year-old male who presented with a one-month history of productive cough, shortness of breath, and fever associated with chills and night sweating. He reported an 8 kg weight loss in the last month. He was found to have pulmonary tuberculosis. On further investigations for leg swelling and tachycardia. Deep vein thrombosis and sub-massive saddle bilateral pulmonary embolism were diagnosed, which was treated with thrombolysis therapy (alteplase). He responded well to initial therapy and was discharged on anticoagulation with anti-tuberculous therapy (ATT).

A rare case of miliary tuberculosis presenting with saddle pulmonary embolism

“…A meta-analysis from 2021 analyzing 16,190 patients found an odds ratio of 2.9 for the development of VTE and 3.58 for the development of PE [ 2 ]. There have been case reports of saddle PE associated with TB as reported by Subahi et al [ 6 ] and Dakhlia et al [ 7 ]. However, in these two case reports the patients were diagnosed with TB first and subsequently developed PE.…”