Pulmonary Tuberculosis with Concurrent Pulmonary Thromboembolism

A young male with no history of tuberculosis or risk factors for pulmonary thromboembolism (PTE) presented with dry cough, streaky hemoptysis, pleuritic chest pain, and breathlessness of 3 days duration.Initial investigations revealed a cavitary lesion in the left lower lobe with minimal pleural effusion.A diagnosis of microbiologically confirmed pulmonary tuberculosis (PTB) was clinched.However, the patient continued to be symptomatic with breathlessness, prompting a clinical suspicion of PTE.D-dimer values were elevated, and subsequently a CT pulmonary angiogram (CTPA) was performed, which revealed a central thrombus partially obstructing the left pulmonary artery with extension of thrombus into the left descending pulmonary artery.The patient was managed with anti-tubercular therapy (ATT) and anticoagulation, with complete recovery in 6 months.