CTICasesActive Pulmonary Tuberculosis with Thromboembolic Complications
Imaging findings
A young diabetic woman in her 30s with cough, dyspnea, and fever has striking bilateral cavitation, greater on the right, with centrilobular nodules at the periphery, consistent with active tuberculosis. About a week into her hospital stay she developed a pulmonary embolism, a left ventricular apical thrombus, and multiple strokes, without a clear explanation (possibly DIC). No filling defect or apical mass was present on the initial scan.
Key takeaways
Advanced active pulmonary tuberculosis with extensive cavitation and centrilobular nodules can be complicated by a hypercoagulable state, here with pulmonary embolism, left ventricular thrombus, and embolic strokes, possibly on the basis of DIC. The rapid development of intracardiac thrombus and systemic emboli in a patient with heavy TB burden is a notable, if incompletely explained, association.
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