A rare case of mycobacterial pseudoaneurysm of the superficial femoral artery

R. Berchiolli, G. Bertagna, P.A. Erba, C. Caroselli, S. Fabiani, L.R. Suardi, M. Falcone, M. Ferrari, N. Troisi

Vascular Surgery Unit, Unit of Nuclear Medicine (P.A.E.), Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy. troisimd@gmail.com

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• Infectious Diseases
• Vascular Medicine

OBJECTIVE: Extrapulmonary localization of tuberculosis accounts for about 15-20% of cases. Several cases of Mycobacterium tuberculosis with vascular involvement have been described, but only few cases for limb vessels.

CASE REPORT: We report the case of a 33-year-old man from Gambia with a symptomatic pseudoaneurysm of the right superficial femoral artery. Total body positron emission tomography/computed tomography with [18F]FDG revealed an active infection. The patient underwent vascular reconstruction with a straight reversed vein graft. Molecular testing for Mycobacterium tuberculosis was non-diagnostic. Cultures of the pseudoaneurysm wall and thrombus removed during surgery grew Mycobacterium tuberculosis.

CONCLUSIONS: The diagnosis of vascular tuberculosis infection due to Mycobacterium tuberculosis is a challenge. Epidemiology remains the primary criterion for maintaining a high index of suspicion.

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