Coexistent Tuberculosis and Pulmonary Embolism: Double Trouble

Abstract Pulmonary tuberculosis (TB) is rampant in developing countries, whereas the reported incidence of pulmonary embolism is low in such patients. Hemoptysis occurs in both conditions, leading to the possibility of missing one diagnosis. We report two patients with TB and pulmonary thromboembolism: the first developing embolism during the evaluation and treatment of disseminated TB and the second presenting with coexistent TB and pulmonary embolism at admission. In developing and underdeveloped countries, respiratory symptoms and signs of pulmonary embolism may be attributed to TB per se alternatively, diagnostic facilities may not be available to confirm pulmonary embolism. In addition, owing to drug interactions, anticoagulation with warfarin becomes a problem with simultaneous rifampicin and isoniazid therapy. Newer oral anticoagulants, as an alternative, lead to increased costs and an increased probability of reduced compliance.