Recurrent gastrointestinal bleeding due to a tuberculous mycotic aneurysm with an aortoduodenal fistula.

摘要

The formation of an aortic aneurysm caused by infection with Mycobacterium tuberculosis is rare. In a recent review of the English literature from 1945 to 1999, only 41 cases of tuberculous mycotic aneurysm of the aorta were identified.1 In this report, we present our experience with one such patient and a brief review of the English Language literature. An 80-year-old man was admitted to our hospital because of a one-week history of recurrent upper gastrointestinal bleeding. During this period, upper gastrointestinal panendo-scopy had failed to show active bleeding. Only a 2-cm Linear ulcer with white base over the high body of the stomach was detected. He was given blood transfusions and a proton pump inhibitor. Eight years before admission, he had had pneumonia of the right middle lobe. Bronchoscopic biopsy had revealed chronic granulomatous inflammation. Sputum mycobacterial culture was negative and he was treated with intravenous penicillin and erythromycin. Four years before admission, he had experienced fever, abdominal pain, and jaundice. An abdominal computerized tomography scan done at that time was negative for an abdominal aneurysm.