Suresh Preethi S, Mathivanan Koushik Muthu Raja
Pulmonary Medicine, Sri Ramachandra Medical College, Chennai, IND.
Respiratory Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2025 Aug 8;17(8):e89662. doi: 10.7759/cureus.89662. eCollection 2025 Aug.
Tuberculosis (TB) is a multisystem infectious disease with both pulmonary and extrapulmonary manifestations. TB can also induce a hypercoagulable state, setting off a cascade of changes in the body, including systemic inflammation, endothelial dysfunction, and abnormalities in the coagulation and fibrinolytic pathways. Collectively, these factors significantly increase the risk of venous thromboembolism, such as deep vein thrombosis and pulmonary embolism. These complications can worsen the overall disease course and complicate TB management. We report the case of a 27-year-old man presenting with high-grade fever, abdominal pain, and significant weight loss. Imaging suggested tuberculous peritonitis, and computed tomography pulmonary angiography revealed pulmonary thromboembolism, a rare but serious TB-associated complication. Omental biopsy confirmed TB based on histopathology and GeneXpert. Despite the initiation of anti-tubercular therapy and anticoagulation, the patient developed osteomyelitis of the right iliac bone with an intramuscular abscess, which tested positive for . This case highlights the thrombotic and multisystemic nature of TB and the need for vigilance in identifying its uncommon complications.
结核病（TB）是一种具有肺部和肺外表现的多系统传染病。结核病还可诱发高凝状态，引发身体一系列变化，包括全身炎症、内皮功能障碍以及凝血和纤维蛋白溶解途径异常。这些因素共同作用，显著增加了静脉血栓栓塞的风险，如深静脉血栓形成和肺栓塞。这些并发症会使整体病程恶化，并使结核病的治疗复杂化。我们报告一例27岁男性病例，该患者出现高热、腹痛和显著体重减轻。影像学检查提示结核性腹膜炎，计算机断层扫描肺动脉造影显示肺血栓栓塞，这是一种罕见但严重的与结核病相关的并发症。网膜活检根据组织病理学和GeneXpert检测确诊为结核病。尽管开始了抗结核治疗和抗凝治疗，但患者仍发生了右髂骨骨髓炎并伴有肌内脓肿，检测结果为阳性。该病例突出了结核病的血栓形成和多系统性质，以及在识别其罕见并发症时保持警惕的必要性。
