Although tuberculosis is a major infectious cause of morbidity and mortality worldwide, death from tuberculosis is uncommon in the United States. Sudden death due to this infection is most frequently a result of tuberculous pneumonia or massive hemoptysis. There are multiple etiologies for massive hemoptysis in pulmonary tuberculosis, including aneurysm formation, bronchial arteritis, lung cavitation, and tuberculous lymphadenitis. The identification of the exact anatomic etiology of massive hemoptysis, such as a fistulous connection or erosion of a pulmonary artery into a bronchus, is rare. We present a case of sudden death due to massive hemoptysis due to erosion of a pulmonary artery into a bronchus as a result of undiagnosed pulmonary tuberculosis.
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