Department of Tuberculosis, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Z-BioMed, Inc., Rockville, Maryland, United States.
J Infect Dev Ctries. 2023 Sep 30;17(9):1351-1355. doi: 10.3855/jidc.17744.
Tuberculosis (TB) is considered one of the two greater long-term global public health threats than the coronavirus disease 2019 (COVID-19) pandemic. Although venous thromboembolism has a low prevalence of 3.5% among patients with active TB, miliary TB complicated by arteriovenous thrombosis is a rare and potentially life-threatening condition.
We present here an unusual case of a 32-year-old man with a two-month history of shortness of breath and painful swelling in the right lower extremity. In addition, elevated plasma levels of platelets, white blood cells, neutrophils, and D-dimer were observed upon his admission to the hospital. The patient was diagnosed with miliary TB complicated by arteriovenous thrombosis in the right lower extremity and a left ventricular mass measuring 3.5 × 1.7 cm. He was successfully treated with anti-TB drugs and low molecular weight heparin followed by warfarin, aspirin and clopidogrel.
This case study demonstrates that a patient with miliary TB complicated by arteriovenous thrombosis and a left ventricular mass can be cured with timely diagnosis and appropriate treatment. The implications of this report are to raise awareness about miliary TB and arteriovenous thrombosis, to improve diagnosis and treatment, and to reduce patient mortality through sharing our successful experience with clinicians and healthcare providers in the developing countries of the world.
结核病（TB）被认为是比 2019 年冠状病毒病（COVID-19）大流行更长期的两大全球公共卫生威胁之一。尽管静脉血栓栓塞在活动性结核病患者中的患病率为 3.5%，但粟粒性结核病合并动静脉血栓形成是一种罕见且潜在危及生命的疾病。
我们在此介绍一例不常见的病例，一名 32 岁男性，有两个月的呼吸急促和右下肢体疼痛肿胀史。此外，患者入院时观察到血小板、白细胞、中性粒细胞和 D-二聚体血浆水平升高。该患者被诊断为右侧下肢粟粒性结核病合并动静脉血栓形成，左心室肿块大小为 3.5×1.7cm。他成功地接受了抗结核药物和低分子量肝素治疗，随后接受了华法林、阿司匹林和氯吡格雷治疗。
本病例研究表明，及时诊断和适当治疗可治愈合并动静脉血栓形成和左心室肿块的粟粒性结核病患者。本报告的意义在于提高对粟粒性结核病和动静脉血栓形成的认识，改善诊断和治疗，并通过与世界发展中国家的临床医生和医疗保健提供者分享我们的成功经验，降低患者死亡率。
