A patient with Tuberculous para-valvular leak and tuberculous hepatic abscesses treated conservatively with anti-tuberculous medication without the need for surgical intervention. “Case report”

Main Article Content

Areeg Magzoub Babiker El Tayeb Mohammed Hassan Ahmed Walid Elhaj Abdelrahim, Associate professor of surgery

Abstract

Introduction:  We report a case of a young lady with rheumatic heart disease who underwent mechanical prosthetic mitral valve replacement and tricuspid valve repair. The case was complicated after one year by multi system tuberculous abscesses, para-valvular leak and hemolytic anemia.


Case summary: The case started one year following mechanical prosthetic mitral valve replacement, and after contact with a tuberculous patient. The lady developed, sterile pyuria, two tuberculous hepatic abscesses, and a big pelvic tuberculous abscess.  She first needed percutaneous drainage for the pelvic abscess followed by laparotomy and surgical drainage after recurrence. The case was complicated by Para-valvular leak in the prosthetic mitral valve detected by Transoesophageal echocardiography as well as refractory hemolytic anemia needing multiple transfusions. She required six months of anti-tuberculous therapy for the hemolysis to stop. Treatment continued for a total of one year of anti-tuberculous therapy. The patient restored normal valve dynamics and hematological parameters without the need for surgical intervention for the para-valvular leak.


Conclusion: We report this case to show that small tuberculous para-valvular leak and hemolytic anemia as well as tuberculous hepatic abscesses can be treated medically as an alternative option to the well-known and recommended surgical indication. We also confirm delayed healing of the abdominal surgical wound due to tuberculosis.

Keywords: Case report, Para-valvular leak, Tuberculous abscess, Hemolytic anemia, Sterile Pyuria

Article Details

How to Cite
EL TAYEB, Areeg Magzoub Babiker; AHMED, Mohammed Hassan; ABDELRAHIM, Walid Elhaj. A patient with Tuberculous para-valvular leak and tuberculous hepatic abscesses treated conservatively with anti-tuberculous medication without the need for surgical intervention. “Case report”. Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5905>. Date accessed: 03 dec. 2024. doi: https://doi.org/10.18103/mra.v12i9.5905.
Section
Case Reports

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