The Radiological Presentation of Rasmussen Aneurysm Secondary to Pulmonary Tuberculosis and COVID-19: A Case Report

Arif, Adnan; Bhinder, Khurram Khaliq; Sarfraz, Azza; Sarfraz, Zouina; Felix, Miguel; Chérrez-Ojeda, Ivan

BACKGROUND: Rasmussen aneurysm is rare diagnosis occurring in patients with long-standing tuberculosis. TB-COVID-19 co-infection in the context of Rasmussen aneurysm is a rare occurrence, yet new cases are emerging. CASE PRESENTATION: An elderly male was recently diagnosed with TB-COVID-19 co-infection and presented with sudden onset massive hemoptysis. The patient was diagnosed with Rasmussen aneurysm after being evaluated by CT pulmonary angiogram due to a suggestive clinical presentation. Interventional radiologists planned for embolization of pulmonary artery, with an unidentifiable source. It was suspected that the patient's source of bleeding was hampered due to local tamponade effect or thrombosis of the aneurysm. The patient remained stable after 24 hours on CT pulmonary angiogram. CONCLUSION: Our case emphasizes the importance of Rasmussen aneurysm as a differential diagnosis when presented with a TB-COVID-19 co-infection and sudden onset of hemoptysis symptomatically and radiologically. The timely diagnosis and management are key to improve mortality.