Kadiyani Lamk, Ramakrishnan Sivasubramanian, Kumar Sanjeev, Ramakrishnan Pradeep
Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, India.
Ann Pediatr Cardiol. 2023 Sep-Oct;16(5):363-366. doi: 10.4103/apc.apc_156_23. Epub 2024 Apr 1.
Tuberculous (TB) involvement of the vascular system has been reported in the preantibiotic era. We, hereby, report a case involving a teenage boy who presented to us with left upper limb pain followed by gradually progressive motor and sensory deficit over 1 month with preceding history of tuberculosis. Examination revealed a palpable, noncompressible, nonpulsatile swelling superior to the lateral third of the clavicle. Imaging through ultrasonography, computed tomography, and magnetic resonance imaging confirmed the presence of a pseudoaneurysm with compression of the underlying nerves. The child underwent surgical thrombectomy with pseudoaneurysm repair and arteriorrhaphy along with antitubercular medications with complete recovery at 6 months. The tissue staining, nucleic acid amplification tests, and histopathology confirmed TB etiology. Tuberculosis continues to remain a major health concern, especially in the developing world. High index of suspicion is necessary to diagnose such manifestations to avoid catastrophic sequelae.
在抗生素时代之前就有关于血管系统结核（TB）累及的报道。在此，我们报告一例病例，一名青少年男性因左上肢疼痛前来就诊，随后在1个月内逐渐出现进行性运动和感觉功能障碍，之前有结核病病史。检查发现锁骨外侧三分之一上方有一个可触及的、不可压缩的、无搏动性肿胀。超声、计算机断层扫描和磁共振成像检查证实存在假性动脉瘤并压迫其下方神经。该患儿接受了手术血栓切除术、假性动脉瘤修复术和动脉修补术，并同时接受抗结核药物治疗，6个月时完全康复。组织染色、核酸扩增试验和组织病理学检查证实为结核病因。结核病仍然是一个主要的健康问题，尤其是在发展中国家。对于诊断此类表现需要高度怀疑，以避免灾难性后果。
