Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy Cases

Tuberculosis (TB) is a communicable disease caused by the organism Mycobacterium tuberculosis. It has been a leading cause of mortality and a global public health emergency for the last 25 years. Despite being a predominantly pulmonary infection, Mycobacterium tuberculosis can affect other organs, s...

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Main Authors: Shalaka Anand Deshpande, Manisha Khare, Prashant V Kumavat, Sneha Janjal
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-04-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/20865/76338_CE[Ra1]_F(SL)_QC(PS_SS)_PF1(AG_SS)_PFA_NC(IS)_PN(IS).pdf
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author Shalaka Anand Deshpande
Manisha Khare
Prashant V Kumavat
Sneha Janjal
author_facet Shalaka Anand Deshpande
Manisha Khare
Prashant V Kumavat
Sneha Janjal
author_sort Shalaka Anand Deshpande
collection DOAJ
description Tuberculosis (TB) is a communicable disease caused by the organism Mycobacterium tuberculosis. It has been a leading cause of mortality and a global public health emergency for the last 25 years. Despite being a predominantly pulmonary infection, Mycobacterium tuberculosis can affect other organs, such as the nervous system, gastrointestinal system and, rarely, the cardiovascular system. This infection can sometimes present as Tuberculous Myocarditis (TM) in the cardiovascular system, an extremely unusual presentation that can be difficult to diagnose, especially in areas where TB is endemic, like India. Authors report four cases of Granulomatous Myocarditis (GM) across a wide range of age groups, who presented with non specific symptoms of giddiness followed by sudden unconsciousness and death. On gross examination of the hearts received after autopsy, two cases showed left ventricular focal white lesions, while one additionally showed Left Ventricular Hypertrophy (LVH). The hearts in the other two cases were grossly unremarkable. Microscopic examination of the cardiac tissue revealed multiple caseating granulomas composed of necrosis, epithelioid cells and lymphocytes. Three out of four cases also showed disseminated TB. Based on the histopathological examination of the granulomas, Mycobacterium tuberculosis aetiology was suspected in all cases. Herein, present series describe the pathological characteristics of this most unusual variant of Mycobacterium tuberculosis.
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spelling doaj-art-b1d787dc895a4bd694dc9769d76727002025-08-20T02:26:55ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-04-01194010310.7860/JCDR/2025/76338.20865Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy CasesShalaka Anand Deshpande0Manisha Khare1Prashant V Kumavat2Sneha Janjal3Senior Resident, Department of Pathology, HBTMC and Dr. RN Cooper Municipal Hospital, Mumbai, Maharashtra, India.Professor and Head, Department of Pathology, HBTMC and Dr. RN Cooper Municipal Hospital, Mumbai, Maharashtra, India.Associate Professor, Department of Pathology, HBTMC and Dr. RN Cooper Municipal Hospital, Mumbai, Maharashtra, India.Assistant Professor, Department of Pathology, HBTMC and Dr. RN Cooper Municipal Hospital, Mumbai, Maharashtra, India.Tuberculosis (TB) is a communicable disease caused by the organism Mycobacterium tuberculosis. It has been a leading cause of mortality and a global public health emergency for the last 25 years. Despite being a predominantly pulmonary infection, Mycobacterium tuberculosis can affect other organs, such as the nervous system, gastrointestinal system and, rarely, the cardiovascular system. This infection can sometimes present as Tuberculous Myocarditis (TM) in the cardiovascular system, an extremely unusual presentation that can be difficult to diagnose, especially in areas where TB is endemic, like India. Authors report four cases of Granulomatous Myocarditis (GM) across a wide range of age groups, who presented with non specific symptoms of giddiness followed by sudden unconsciousness and death. On gross examination of the hearts received after autopsy, two cases showed left ventricular focal white lesions, while one additionally showed Left Ventricular Hypertrophy (LVH). The hearts in the other two cases were grossly unremarkable. Microscopic examination of the cardiac tissue revealed multiple caseating granulomas composed of necrosis, epithelioid cells and lymphocytes. Three out of four cases also showed disseminated TB. Based on the histopathological examination of the granulomas, Mycobacterium tuberculosis aetiology was suspected in all cases. Herein, present series describe the pathological characteristics of this most unusual variant of Mycobacterium tuberculosis.https://jcdr.net/articles/PDF/20865/76338_CE[Ra1]_F(SL)_QC(PS_SS)_PF1(AG_SS)_PFA_NC(IS)_PN(IS).pdfepithelioid cellshearthistopathologypostmortemsudden death
spellingShingle Shalaka Anand Deshpande
Manisha Khare
Prashant V Kumavat
Sneha Janjal
Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy Cases
Journal of Clinical and Diagnostic Research
epithelioid cells
heart
histopathology
postmortem
sudden death
title Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy Cases
title_full Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy Cases
title_fullStr Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy Cases
title_full_unstemmed Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy Cases
title_short Granulomatous Myocarditis as Rare Presentation of Mycobacterium tuberculosis: A Series of Four Autopsy Cases
title_sort granulomatous myocarditis as rare presentation of mycobacterium tuberculosis a series of four autopsy cases
topic epithelioid cells
heart
histopathology
postmortem
sudden death
url https://jcdr.net/articles/PDF/20865/76338_CE[Ra1]_F(SL)_QC(PS_SS)_PF1(AG_SS)_PFA_NC(IS)_PN(IS).pdf
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AT manishakhare granulomatousmyocarditisasrarepresentationofmycobacteriumtuberculosisaseriesoffourautopsycases
AT prashantvkumavat granulomatousmyocarditisasrarepresentationofmycobacteriumtuberculosisaseriesoffourautopsycases
AT snehajanjal granulomatousmyocarditisasrarepresentationofmycobacteriumtuberculosisaseriesoffourautopsycases