Tuberculous pericarditis-a silent and challenging disease: A case report

Abstract

BACKGROUND Tuberculous pericarditis (TP) remains a challenge for endemic countries. In developing countries, one to two percent of patients with pulmonary tuberculosis develops TP. CASE SUMMARY A 49-year-old woman presented with dyspnea, chest pain and dry cough. On physical examination, veiled heart sounds were found. The electrocardiogram showed low-voltage complexes and the transthoracic echocardiography revealed a large and free-looking pericardial effusion. The patient was taken for an open pericardiotomy. The pericardial fluid revealed high levels of adenosine deaminase and Ziehl-Neelsen stain showed acid-fast bacilli. Polymerase chain reaction study for Mycobacterium tuberculosis in pericardial fluid was positive. The patient received tetra conjugate management with adequate clinical response after the first week of treatment and resolution of fever and chest pain. CONCLUSION In cases of TP, obtaining pericardial fluid and/or pericardial biopsy is the most efficient strategy to confirm the diagnosis. Early diagnosis of this entity will allow physicians to initiate timely treatment, avoid complications and improve the patient's clinical outcome, so we consider the description of this case pertinent and its review in the literature.

Assessing the hazard of death, cardiac tamponade, and pericardial constriction among HIV and tuberculosis pericarditis patients using the extended Cox‐hazard model: Intervention study

“…The IMPI trial investigated the effects of two TB treatments, prednisolone and Mycobacterium indicus pranii ( M. indicus pranii ) immunotherapy, in patients with TBP patients in Africa. TBP is a TB that occurs in the heart and is an important complication of TB, which diagnosis can be difficult to establish and is often delayed or missed, resulting in late complications such as composite outcome (death, cardiac tamponade, or pericardial constriction) and increased mortality 42 . Patient who met the inclusion criteria, defined in the IMPI trial study, were randomized into four treatment arms.…”

“…TBP is a TB that occurs in the heart and is an important complication of TB, which diagnosis can be difficult to establish and is often delayed or missed, resulting in late complications such as composite outcome (death, cardiac tamponade, or pericardial constriction) and increased mortality. 42 Patient who met the inclusion criteria, defined in the IMPI trial study, were randomized into four treatment arms. Randomized patients received the combination of either or or or , where and denote the M. indicus pranii and its corresponding placebo arm and and denote prednisolone and its corresponding placebo arm, respectively.…”

Tuberculous Pericardial Effusion With Pleural Effusion in an Indian Female: A Rare Case

“…Clinical features of both pericardial effusion and pleural effusion are non-specific like dyspnea, cough with or without expectoration, chest pain, night sweats, orthopnea, weight loss, and lower limb edema [8].…”

A 15-year-old girl with pericardial tuberculosis complicated by cardiac tamponade: A case report in Somalia

“…On echocardiography, tuberculous pericarditis is frequently associated with pericardial effusion and thickening of the visceral pericardium, and fibrin bands that heal with pericardial fibrosis [ 13 ]. The echo of our patient showed circumferential fibrinous pericardial effusion and thick pericardial wall.…”