Tubercular Vasculitis: A Rare Occurrence

Tuberculosis (TB) is a community-acquired disease, caused by Mycobacterium tuberculosis, largely prevalent in Southeast Asian countries. Pulmonary and extrapulmonary TB in India is rampant, and a national program has been implemented for treatment and to reduce the incidence of the disease. Extrapul...

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Bibliographic Details
Main Authors: Abhijit Acharya, Anusha Preethi, Shakti Bedanta Mishra, Sagarika Panda, Sumirini Puppala
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:International Journal of Mycobacteriology
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Online Access:https://journals.lww.com/10.4103/ijmy.ijmy_218_24
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Summary:Tuberculosis (TB) is a community-acquired disease, caused by Mycobacterium tuberculosis, largely prevalent in Southeast Asian countries. Pulmonary and extrapulmonary TB in India is rampant, and a national program has been implemented for treatment and to reduce the incidence of the disease. Extrapulmonary TB in the form of the central nervous system (CNS) TB is rare. CNS TB can affect both the brain and spine. In the brain, they present as tubercular meningitis, solitary tubercular granulomas, and rarely, vasculitis or infarcts. In the spine, they present in the form of pain, spinal deformities, motor and sensory deficits, etc., We, at this moment, present a case of a 32-year-old male patient who has a known case of disseminated TB, was diagnosed 4 months prior, and was on ATT category first-line drugs for 4 months. He presented with a history of abdominal pain, distention, and nonpassage of stool and flatus. He was evaluated by imaging and was diagnosed with perforation with peritonitis. He underwent surgery with exploratory laparotomy and primary repair of the perforation and proximal loop ileostomy. The sensorium of the patient deteriorated rapidly from POD 1. He was evaluated with a computed tomography brain and was diagnosed with multiple infarcts in the brain due to tubercular vasculitis which is a rare complication of the disseminated TB. What’s New? Multiple brain infarcts are very rare in patients with extrapulmonary TB. Patients with disseminated TB with specific involvement of CNS have a high incidence of mortality and morbidity patients.
ISSN:2212-5531
2212-554X