Sudden Death from Tubercular Myocarditis

Abstract

Tuberculous myocarditis is a rare finding. We present the case of a 33-year-old woman who was in good health and who died suddenly at home. Autopsy and histopathologic examinations revealed granulamatous lesions in the myocardium, lungs, lymph nodes, liver, and spleen. No fast acid bacilli were demonstrated on histological examination. The presence of a Mycobacterium tuberculosis DNA complex was identified using a polymerase chain reaction (PCR) on formalin-fixed paraffin-embedded histological samples. An HIV test carried out on the blood obtained during the autopsy was negative according to the DNA amplification technique (PCR) and enzyme-linked immunosorbent assay serological test. We hypothesize that the mechanism of death was severe ventricular arrhythmia due to granulomatous proliferation in the structures of the interventricular septum.

Detection of Mycobacterium tuberculosis DNA by polymerase chain reaction from paraffin samples of chronic granulomatous endometritis

“…On the other hand, since the clinical diagnosis of tuberculosis may also be difficult, clinicians often have to rely on histology. A dramatic improvement in sensitivity and specificity of the diagnosis of mycobacterial diseases has been achieved in recent years with the development of molecular techniques 3–5 . We explored the feasibility of detection of Mycobacterium tuberculosis DNA by polymerase chain reaction (PCR) in paraffin‐embedded tissues of the endometrium and compared the results with the previous morphological diagnosis.…”

Sudden death due to pulmonary aspergillosis

“…1,[7][8][9][10][11] Death from TB may sometimes have a rapid onset and progression. There are a number of reasons why TB cases are ''missed" and are identified and reported at autopsy.…”

Sudden death related to tuberculous coronary arteritis

“…According to Rose AG, the first report of myocardial tuberculosis was made by Maurocordat in 1664 [6]. Since then, other cases have been reported but they are nevertheless very unusual [3][4][5][6]. According to the revised literature, to date this is the first report of tuberculous coronary arteritis leading to sudden death.…”

“…The presence of acid fast bacilli was demonstrated with the Ziehl Neelsen technique. PCR with primers specific for the insertion element IS6110 detected the presence of M. tuberculosis complex DNA [5].…”