Dissecting aortic root aneurysm and severe aortic regurgitation following pulmonary tuberculosis

Aneurysms of the aortic root and ascending aorta are often due to degenerative disease of media but tuberculosis is an important but extremely rare cause of aortic root dilatation especially in tropical countries like India where tuberculosis is endemic. Tubercular aneurysmal dilatation of aorta with dissection leading to aortic regurgitation is a rare but important complication of tuberculosis. With worldwide resurgence of tuberculosis due to increasing incidence of drug-resistant tuberculosis and its association with acquired immunodeficiency syndrome, the tubercular aneurysm has become a real clinical entity. Although tubercular aortitis is fairly common, tuberculous mycotic aneurysm of the aorta is rare, with involvement of the aortic root being exceedingly uncommon.Here we describe a case of 18 year old male presenting with severe breathlessness and was found to have dissecting aortic root aneurysm with aortic regurgitation with active pulmonary tuberculosis and spinal deformity in the form of kyphoscoliosis. He underwent a Bentall procedure, and excised aortic root tissue showed epithelioid cell granulomas with panarteritis.