An Atypical Presentation of Tuberculosis With the Involvement of the Thoracic Aorta

Tuberculous aortitis (TA) is a rare complication of Mycobacterium tuberculosis (TB) characterized by persistent inflammatory infiltration and weakening of the aortic wall. The disease most commonly results from contiguous spread from adjacent infected tissue and can lead to life-threatening complications, notably pseudoaneurysm formation and aortic rupture. The present case describes a 66-year-old man with sudden-onset back pain and hemoptysis. He was initially found to have a penetrating aortic ulcer (PAU), but subsequent radiographic imaging and recurrent hospitalizations later revealed aortic findings more consistent with TA. This report highlights the rarity of TA co-occurring with a PAU and emphasizes existing treatment plans for this clinical scenario.