Tuberculous pseudoaneurysm of the renal artery: A rare manifestation of extra-pulmonary tuberculosis

Mycotic pseudoaneurysms are rare dilations of the arterial wall caused by infection. We present a case of a 62-year old man with disseminated tuberculosis and a large mycotic pseudoaneurysm involving the main renal artery and vein. Despite being on appropriate rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE) therapy, the pseudoaneurysm grew with increasing concern for potential rupture. The patient subsequently underwent an open right simple nephrectomy with resection of the pseudoaneurysm, partial resection of the inferior vena cava, and reconstruction.