Clerc Olivier, Jaton Katia, Prod'hom Guy, Von Segesser Ludwig, Greloz Vincent, Greub Gilbert
Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
J Med Case Rep. 2008 Jul 18;2:233. doi: 10.1186/1752-1947-2-233.
Mycobacterium tuberculosis may cause a large variety of clinical presentations due to its ability to disseminate by contiguity or hematogenously. Tuberculosis may remain undiagnosed for years due to the chronic course of the disease, with potentially life-threatening long-term complications.
In this case report, we describe a tuberculous aortic graft infection in a 72-year-old man documented by polymerase chain reaction and cultures. The patient presented with three episodes of hemoptysis following a remote history of miliary tuberculosis. The infection was treated by graft replacement and prolonged antimycobacterial therapy.
Tuberculous infection of a vascular graft is an uncommon complication, but should be considered in patients with an intravascular device and a history of previous tuberculosis, especially when hematogenous spread may have occurred a few months after surgery, or when an active mycobacterial infection is present in close proximity to the graft.
结核分枝杆菌因其能够通过连续性或血行播散,可导致多种临床表现。由于疾病病程呈慢性,结核病可能多年未被诊断,从而产生潜在危及生命的长期并发症。
在本病例报告中,我们描述了一名72岁男性患者,经聚合酶链反应和培养确诊为结核性主动脉移植物感染。该患者在有粟粒性结核病史后出现了三次咯血。感染通过移植物置换和延长抗分枝杆菌治疗得以治愈。
血管移植物的结核感染是一种罕见的并发症,但对于有血管内装置且既往有结核病史的患者应予以考虑,特别是当术后数月可能发生血行播散,或移植物附近存在活动性分枝杆菌感染时。