A 65 year old female patient presented with one episode of massive haemoptysis requiring transfusion and subsequently cough with streaky haemoptysis. Computerized tomographic scan and angiogram revealed aneurysm of the distal aortic arch. She underwent elective repair of the psuedoaneurysm through median sternotomy and the bronchial communication was closed through left thoracotomy. Tubercle bacilli were identified in the contents and excised wall of aortic tissue.
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