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[62] Krajewska M, Zabost A, Welz M, Lipiec M, Orłowska B, Anusz K, Brewczyński P, Augustynowicz-Kopeć E, Szulowski K, Bielecki W, Weiner M. Transmission of *Mycobacterium caprae* in a herd of European bison in the Bieszczady Mountains, Southern Poland. Eur J Wildl Res. 2015;61:429- 433. DOI: 10.1007/s10344-015-0912-x

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[69] Smith NH, Upton P. Naming spoligotype patterns for the RD9 deleted lineage of the *Mycobacterium tuberculosis* complex; www.Mbovis.org. Infect Genet Evol. 2012;12:873-876. DOI: 10.1016/j.meegid.2011.08.002

[70] Kamerbeek J, Schouls L, Kolk A, van Agterveld M, van Soolingen D, Kuijper S, Bunschoten A, Molhuizen H, Shaw R, Goyal M, van Embden J. Simultaneous detection and strain differentiation of *Mycobacterium tuberculosis* for diagnosis and epidemiology. J Clin Microbiol. 1997;35:907-914. DOI: 10.1128/ JCM.35.4.907-914.1997

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**99**

Section 5

Other TB

Section 5 Other TB

*Molecular Epidemiology Study of Mycobacterium Tuberculosis Complex*

[68] Mazur J. Wisents in Forest District Stuposiany. Europ Bison Conserv

Newslett. 2013;6:133-144.

[69] Smith NH, Upton P. Naming spoligotype patterns for the RD9 deleted lineage of the *Mycobacterium tuberculosis* complex; www.Mbovis.org. Infect Genet Evol. 2012;12:873-876. DOI:

10.1016/j.meegid.2011.08.002

JCM.35.4.907-914.1997

[71] Alonso-Rodríguez N, Martínez-Lirola M, Herránz M,

DOI: 10.1186/1471-2180-8-34

Sanchez-Benitez M, Barroso P. Evaluation of the new advanced 15-loci MIRU-VNTR genotyping tool in *Mycobacterium tuberculosis* molecular epidemiology studies. BMC Microbiol. 2008;24:8-34.

[70] Kamerbeek J, Schouls L, Kolk A, van Agterveld M, van Soolingen D, Kuijper S, Bunschoten A, Molhuizen H, Shaw R, Goyal M, van Embden J. Simultaneous detection and strain differentiation of *Mycobacterium tuberculosis* for diagnosis and epidemiology. J Clin Microbiol. 1997;35:907-914. DOI: 10.1128/

**98**

**101**

**1. Introduction**

extremely rarely affected.

**Chapter 7**

Disease

**Abstract**

*and Mohamed Ali Sbai*

Humeral Artery Aneurysm

*Rabie Ayari, Ramy Triki, Youssef Mallat,* 

*Achraf Abdennadher, Khalil Amri, Raja Amri* 

sis complicates management and requires close monitoring.

**Keywords:** Behçet's disease, tuberculosis, aneurysm, humeral artery, imaging

Behçet's disease is an inflammatory, systemic vasculitis originally described by the Turkish dermatologist Hulusi Behçet in 1937. It is typically characterized by the combination of recurrent oral and genital aphtosis with ocular involvement. Vascular involvement in Behçet's disease occurs in 5 to 40% of cases depending on the series [1] and is associated with increased mortality [2]. Venous thrombosis is frequently observed, while arterial damage such as aneurysms, pseudoaneurysms, strictures and occlusions are less reported [2]. Arterial involvement in Behçet's disease mainly affects the aorta and pulmonary arteries. The humeral artery is

Revealing a Rare Association

between Tuberculosis and Behçet's

The association of pulmonary tuberculosis and Behçet's disease revealed by an aneurysm of the humeral artery is exceptional with a complicated management. We report a case in which the two conditions occurred concomitantly with the vascular complication, apart from any use of immunosuppressive therapy, something that has never been reported in the literature. We report an extremely rare case of a spontaneous rupture of an aneurysm of the humeral artery of a 29-year-old woman, with no history. The patient underwent axillo-humeral bypass. Investigations concluded the diagnosis of Behçet's disease associated with pulmonary and lymph node tuberculosis. Anti-tuberculous chemotherapy followed by corticosteroids, immunosuppressants and colchicine have been administrated. Based on this observation, we insist on the necessity of searching the symptoms of Behçet's disease in the presence of arterial involvement when having a young patient. Therapeutic management must include medical treatment to control inflammation and limit the risk of recurrence. Endovascular or surgical treatment is necessary if the arterial involvement is threatening. The association with tuberculo-
