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Tuberculous aortic insufficiency. Report of a case with successful surgical treatment.

A case of endocardial tuberculoma of the left atrium in a 20-year-old woman is presented. Ulceration of the tuberculoma at the aortic anulus led to disruption of the aortic valvular attachment and induced severe aortic insufficiency. Replacement of the aortic valve and administration of antituberculous medication permitted an uneventful recovery. This is probably the first case of tuberculous aortic insufficiency diagnosed in a living patient and surgically treated with the use of extracorporeal bypass.

Adult↗

Submitral left ventricular tuberculoma.

A 62-year-old woman suffered from increasing dyspnea and an impaired general condition. Chest roentgenograms and echocardiogram showed a dense mass at the left atrioventricular junction resulting in the preoperative working diagnosis of a myocardial myxoma. Intraoperatively, an isolated tuberculoma was found caudal to the posterior leaflet of the mitral valve. This case report describes the successful surgical and postoperative medical treatment of an isolated myocardial tuberculoma.

Antitubercular Agents↗

[Fever of unknown origin and tuberculous aortitis].

We present the case of a silicotic patient, with recurrent febrile episodes during the past three years, who was hospitalized for the study of prolonged fever. In addition to compliance with the criteria of fever from unknown origin (FUO), the patient presented semiology and echocardiogram compatible with infectious endocarditis. Later on, he developed a severe aortic failure refractary to medical treatment and hence, he underwent surgery. The surgical intervention showed an abscess in the aortic root, which resulted to be of a tuberculous origin and an intact aortic valve. The review of the echocardiographic study allowed the detection of an image compatible with aortic abscess. We comment on the characteristic of this rare entity and the peculiarities of this case, which fulfill the criteria of what has been recently named recurrent or episodic FUO and among whose causes Mycobacterium tuberculosis had not been detected up to now.

Aortitis↗

[Phlebitis of infectious etiology].

Various infections are sometimes at the origin of phlebitis. Because of the different therapeutic consequences, this etiology should be considered whether it is a case of deep phlebitis of a limb, migratory recurrent phlebitis, or the type of phlebitis called "iron wire". The principal diseases that may lead to phlebitis are : tuberculosis, typhoid fever, rickettsiosis, and streptococcal, staphylococcal, and pneumococcal infections. Certain viruses may have a role but so far there is no formal proof. Focal pathology of dental or tonsillar origin involves in some cases an aseptic venous lesion. Bacterial or mycotic suppurative thrombophlebitis related to an intravenous catheter is the price paid for the use, often unnecessarily, of this method of perfusion.

Bacterial Infections↗

Tuberculosis of the renal artery.

A young female who underwent nephrectomy for renovascular hypertension was diagnosed on histology to have tuberculosis of the renal artery. This was an isolated finding as there was no tuberculous infection elsewhere including tissues in the vicinity of the vessels. A survey of literature did not yield any reports of tuberculous renal arteritis, making this the first such case.

Adult↗

[Two cases of tuberculous pericarditis--diagnostic difficulties].

Some difficulties etiological diagnosis were presented in an example of two clinical cases. In the first patient with exudative pericarditis tuberculosis was determined in histopathological examination of lymph node (caseous necrosis). After antituberculotic treatment the majority of clinical symptoms was disappeared. In the second patient with chronic constrictive pericarditis the tuberculous etiology was accepted according to highly positive tuberculin reaction and signs of pericardial calcification. Patient was qualified to pericardiectomy.

Adult↗

[Height, weight and body mass index of men and women aged 40-42 years].

All men and women aged 40-42 years in Norway (except in Oslo, the capital city) were invited to tuberculosis and cardiovascular screenings during the period 1963-95. Height and weight were measured. Men who attended the last screening in 1991-95 were on average 3.0 cm taller than the generation who attended the first screening (1963-75). Women who were measured in 1991-95 were 2.7 cm taller. Mean weight increased 5.6 kg for men and 1.3 kg for women, while body mass index (BMI) increased 0.9 kg/m2 for men and decreased 0.3 kg/m2 for women. BMI has increased steadily in men, but in women a U-shaped time trend was found with a somewhat lower level for the last time period. The proportion with BMI above 30 kg/m2 has doubled among men and is now 9.1%, while in women the proportion has become slightly lower in the last period, and is now 8.4%. The mean BMI was highest in ex-smokers and lowest in current smokers, with persons who had never smoked in the middle. The difference between ex-smokers and current smokers was 0.9 kg/m2 in men and 0.7 kg/m2 in women.

Adult↗

[The diagnostic difficulties in a current course of infectious endocarditis].

The paper reports 152 cases of infectious endocarditis observed in two Moscow hospitals. Accurate diagnosis of the disease is complicated by frequent nosocomial endocarditis, endocarditis occurrence in aged patients the diagnosis in whom requires differentiation with tumors, lymphogranulomatosis, blood diseases, etc. To make the diagnosis easier, transesophageal echocardiography and comparison of clinical and echo-CG findings were practiced.

Adult↗

[Tumor in the right cardiac chambers. Regression after antitubercular treatment. Apropos of a case].

The authors report the case of a young patient with a tumour of the right atrium and right ventricular outflow tract without visceral complications but with multiple muscular and skin localisations. The diagnosis of tuberculosis was made on biopsy of a suppurating skin lesion. The diagnosis of tuberculosis was made on biopsy of a suppurating skin lesion. Anti-tuberculosis treatment resulted in regression of these tumours, especially the cardiac lesions, confirmed by transoesophageal echocardiography.

Adult↗