Deep vein thrombosis of the left arm revealing an asymptomatic pulmonary tuberculosis

BMJ Case Rep. 2019 Jun 2;12(6):e229484. doi: 10.1136/bcr-2019-229484.

Abstract

Although not frequent, thromboembolic events occurring in patient presenting tuberculosis may be observed. Frequency of such thromboembolic events seems correlated with the severity of tuberculosis. We herein report a case of venous thrombosis revealing an asymptomatic tuberculosis. A man aged 32 years was admitted for deep and superficial vein thrombosis of the left arm. Chest CT angiography ruled out pulmonary embolism and showed a mediastinal and pulmonary heterogeneous necrotic mass at the apical segment of the left lung. Histological study of a CT scan-guided pulmonary biopsy showed signs of caseating granuloma compatible with tuberculosis. Diagnosis of venous thrombosis due to pulmonary tuberculosis with lymph nodes involvement was made. Antituberculosis treatment was initiated and required an adjustment of anticoagulant therapy. Our observation highlights the possibility of causative effect between tuberculosis and venous thrombosis.

Keywords: TB and other respiratory infections; venous thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / therapeutic use
  • Arm / blood supply
  • Axillary Vein*
  • Computed Tomography Angiography
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Humans
  • Male
  • Subclavian Vein*
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / diagnostic imaging
  • Tuberculosis, Pulmonary / pathology
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnosis*
  • Venous Thrombosis / diagnostic imaging

Substances

  • Anticoagulants
  • Antitubercular Agents