Arteriovenous fistula originating from a Rasmussen aneurysm: Beyond pulmonary tuberculosis.
Lina María Garzón López, Alejandro Salgado, Valeria Granados et al.
✦ AI-curated · Sources linked
Case in brief
A 23-year-old immunocompetent male with cavitary pulmonary tuberculosis experienced massive hemoptysis, leading to hemorrhagic shock and acute respiratory failure. Emergency angiography revealed an arteriovenous fistula and a Rasmussen aneurysm in the right pulmonary artery, which were treated with endovascular embolization, achieving immediate hemostasis. Further evaluation identified concomitant pulmonary aspergillosis, prompting a modification of antituberculosis treatment and initiation of antifungal therapy, resulting in clinical improvement.
Diagnostic / clinical pearl
Clinicians should consider the possibility of vascular lesions and coexisting infections, such as pulmonary aspergillosis, in patients with life-threatening hemoptysis associated with tuberculosis.
Why it matters
This case illustrates the importance of a multidisciplinary approach in managing complex complications arising from pulmonary tuberculosis, emphasizing the need for thorough evaluation and tailored treatment strategies.