PULMONARY THROMBOEMBOLISM IN A PATIENTS OF PULMONARY TUBERCULOSIS: AN UNCOMMON OCCURRENCE.

Tuberculosis has a high prevalence in India but pulmonary embolism is rarely reported in Mycobacterium tuberculosis infection. We describe a case series of pulmonary embolism associated with severe pulmonary tuberculosis. In our first case pulmonary embolism (PE) occurred within 6months of pulmonary tuberculosis diagnosis.Patient took ATT for 6 months and after being diagnosed as a case of PE, low-molecular-weight heparin was prescribed for 3 days and after that he was given Tab. warfarin (5mg) OD. Our second case diagnosed as a case of PE after taking 9months of ATT and he also prescribed Tab.Warfarin and low molecular weight heparin. The association between tuberculosis and pulmonary embolism is rare. Tuberculosis, the disease can itself lead to hypercoagulability, increased venous stasis, and endothelial dysfunction, thus increasing the susceptibility to venous thromboembolism (VTE) particularlyin those with severe pulmonary or disseminated tuberculosis. Among the ATT drugs, most commonly associated with thromboembolic events is Rifampicin, an enzyme inducer, and may alter the balance of anticoagulant and coagulant proteins produced by the liver. But it should be in detailed investigation should be done by respiratory physicians to rule out etiology whether it is due to drug or disease itself.