HaemorrhagicMycobacterium aviumcomplex pericarditis presenting with cardiac tamponade in an immunocompetent woman

Abstract

A young woman in her mid-40s was referred by her primary care physician for fever, worsening shortness of breath, pleuritic chest pain and tachycardia. CT angiogram of the chest revealed a large pericardial effusion. Echocardiogram confirmed tamponade physiology despite her being haemodynamically stable. She had an emergency pericardiocentesis which revealed evidence of a haemorrhagic pericardial effusion. However, the patient was still symptomatic after treatment and had to undergo video-assisted thoracoscopic surgery with a pericardial window and chest tube. Postoperatively, her fevers resolved. Pan-culture was initially negative, and all antibiotics were discontinued. Acid-fast bacilli cultures later grewMycobacterium aviumcomplex. She continued to have chest discomfort postoperatively, but follow-up CT of the chest 3 months postoperatively showed continued resolution of her pericardial effusion. The patient’s symptoms improved, and she has had no recurrence of effusion without the need for anti-tuberculosis drugs.

A Rare Case of Cardiac Tamponade Induced by Chronic Lymphocytic Leukemia

“…His only positive findings were dyspnea, orthopnea, and pedal edema. Due to the slower rate of effusion in malignancies, the elastic fibrils adapt, maintaining normal hemodynamics with a higher volume-to-pressure ratio [ 8 ]. Meanwhile, rapid accumulation leads to swift hemodynamic compromise seen in typical cases of cardiac tamponade.…”