Ventricular tachycardia in a disseminated MDR-TB patient: a case report and brief review of literature

doi:10.1007/s11684-014-0321-7

Front. Med.

2014, Vol. 8

Issue (2) : 259-263 https://doi.org/10.1007/s11684-014-0321-7

CASE REPORT

Ventricular tachycardia in a disseminated MDR-TB patient: a case report and brief review of literature

Hui Li¹,Ran Li¹,Jiuxin Qu¹,Xiaomin Yu¹,Zhixin Cao²,Yingmei Liu¹,Bin Cao^1,^*(

)

1. Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China
2. Department of Respiratory Medicine and Critical Care, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China

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Abstract

Although significant breakthroughs have been achieved in tuberculosis management, we still encounter numerous difficulties in diagnosis and treatment of the disease. Additionally, a new challenge, multidrug-resistant tuberculosis (MDR-TB) with unspecific clinical presentation, often results in delayed diagnosis. In this paper, we reported a case of disseminated tuberculosis with rare presentation of ventricular fibrillation, which proved resistant to both isoniazid and rifampicin. A review of literature showed that ventricular fibrillation or tachycardia in tuberculosis patients with pericarditis or myocarditis has been sporadically reported in the past, but none has been conducted involving patients with MDR-TB infections.

Keywords tuberculosis MDR-TB ventricular tachycardia

Corresponding Author(s): Bin Cao

Issue Date: 21 May 2014

Cite this article:

Bin Cao,Hui Li,Ran Li, et al. Ventricular tachycardia in a disseminated MDR-TB patient: a case report and brief review of literature[J]. Front. Med., 2014, 8(2): 259-263.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0321-7
https://academic.hep.com.cn/fmd/EN/Y2014/V8/I2/259

Fig.1 Enhanced CT scan showing a few small nodules in the right lung (A, arrow), enlarged mediastinal lymph nodes (B, arrow), and enlarged liver and spleen accompanied by well-defined ovoid low-density lesions (C, arrow).

Fig.2 (A) Computed tomography showed bone destruction in the right ankle (arrow). (B) Enhanced computed tomography of the brain revealed multiple lesions with ring-like enhancement in the edge (arrows). (C) Chest computed tomography showed disseminated nodules in both lungs with pleural effusion. (D) Disseminated tubercules could be seen in both lungs. (E) Electrocardiogram recorded from the patient when she complained of palpitation. Ventricular fibrillation featured by the disappearance of QRS wave, which was replaced by f wave.

Fig.3 Identification of acid-fast bacilli from sputum and bone marrow. (A) Acid-fast bacilli could be found in the sputum smear (arrows). (B and C) Bone marrow (B) and sputum (C) culture were both positive for M. tuberculosis, with the cord factors being found.

Fig.4 Two-dimensional echocardiogram before antituberculosis (June 20, 2012) (A, B) and after 2 months of antituberculosis treatment (C, D). (A, B) The left ventricular chamber was slightly enlarged, with decreased motion of both ventricles, and no vegetation was noticed. (C, D) Fibrosis changes were found in the left ventricular wall (arrow), with the left ventricular ejection fraction at 66%.

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