2022 Volume 31 Issue 4 Pages 189-192
We report a rare case of tuberculous pseudoaneurysm after COVID-19 that was difficult to diagnose. A 73-year-old man was hospitalized for 4 weeks with COVID-19. Four weeks after discharge from the hospital, he developed a fever, followed by redness, swelling, and pain in the left elbow. CT showed suspected cellulitis. MRI showed suspected cellulitis, abscess, and aneurysm. Ultrasonography of the swollen area of the left elbow revealed a 37 mm pseudoaneurysm that was partially thrombosed and originated from the brachial artery. The patient was admitted to hospital, and underwent thrombus removal and fistula closure under local anesthesia. Postoperatively, the fever persisted, and a CT scan performed on the 8th postoperative day showed diffuse granular shadows in both lung fields, suggesting miliary tuberculosis. PCR tests of sputum and the excised thrombus were positive for Mycobacterium tuberculosis, leading to a diagnosis of miliary tuberculosis and tuberculous pseudoaneurysm. Pathological examination of the excised thrombus confirmed the presence of acid-fast bacilli. The patient was transferred to another hospital for tuberculosis treatment, which resolved his symptoms and he was discharged.
