Tuberculosis de aorta ascendente con Enfermedad de Poncet

Resumen La tuberculosis cardiovascular constituye entre 1-3% de los casos de tuberculosis extrapulmonar. En paises en vias de desarrollo es causante de 38- 83% de los casos de pericarditis constrictiva cronica, mientras que en los paises desarrollados, el porcentaje es del 1%. Es mas frecuente en hombres entre 30-50 anos de edad. Caso: paciente masculino de 36 anos de edad quien 2 meses previos a su ingreso, refiere tos con expectoracion verdosa y disnea de 15 dias de evolucion. Se asocia proptosis indolora, limitacion para la motilidad ocular, artritis simetrica, aditiva, ascendente desde tobillos hasta rodillas, luego munecas y codos. Durante hospitalizacion requiere multiples pericardiocentesis, por lo cual, se realiza pericardiectomia anterior con hallazgo en biopsia de aorta ascendente: inflamacion cronica granulomatosa, BAAR positiva. Se plantea diagnostico de TBC extrapulmonar: TBC de aorta ascendente complicada con derrame pericardico, TBC ocular derecha y artritis reactiva por tuberculosis (Enfermedad de Poncet). La tuberculosis cardiovascular constituye una enfermedad poco comun, de dificil diagnostico que conlleva a consecuencias graves si no se trata oportunamente.  Abstract Cardiovascular tuberculosis occurs in 1-3% of cases of extrapulmonary tuberculosis. In developing countries causes 38-83% of cases of chronic constrictive pericarditis, while in developed countries it represents 1%. It is more common in men between 30-50 years of age. We present a 36 year old male patient, who two months prior admission, referred productive cough and dyspnea during 15 days. Painless proptosis, limitation of ocular motility, symmetric, additive, ascending arthritis from ankles to knees, wrists and elbows were then associated. During his hospitalization multiple pericardiocentesis were performed, requiring pericardiectomy. The findings in ascending aorta biopsy were: granulomatous chronic inflammation, positive for alcohol resistant bacillus. Final diagnosis : tuberculosis of ascending aorta complicated with pericardial effusion, right eye tuberculosis and reactive arthritis tuberculosis (Poncet´s disease) .Cardiovascular tuberculosis is a rare disease difficult to diagnose which leads to serious consequences without timely treatment.