TY - JOUR
T1 - Tuberculous pericarditis-a silent and challenging disease
T2 - A case report
AU - Lucero Pantoja, Oscar David
AU - Bustos Claro, Marlon Mauricio
AU - Ariza-Rodríguez, Darwin Jhoan
AU - Pérez-Correa, Juan Camilo
PY - 2022/2/26
Y1 - 2022/2/26
N2 - BACKGROUNDTuberculous pericarditis (TP) remains a challenge for endemic countries. In developing countries, one to two percent of patients with pulmonary tuberculosis develops TP.CASE SUMMARYA 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.CONCLUSIONIn 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.
AB - BACKGROUNDTuberculous pericarditis (TP) remains a challenge for endemic countries. In developing countries, one to two percent of patients with pulmonary tuberculosis develops TP.CASE SUMMARYA 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.CONCLUSIONIn 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.
KW - Tuberculosis; Pericardial disease; Tuberculous pericarditis; Pericardial effusion; Mycobacterium tuberculosis; Case report
KW - Tuberculosis
KW - Pericardial disease
KW - Tuberculous pericarditis
KW - Pericardial effusion
KW - Mycobacterium tuberculosis
UR - https://www.wjgnet.com/2307-8960/full/v10/i6/1869.htm
U2 - 10.12998/wjcc.v10.i6.1869
DO - 10.12998/wjcc.v10.i6.1869
M3 - Article
SN - 2307-8960
VL - 10
SP - 1869
EP - 1875
JO - World Journal of Clinical Cases
JF - World Journal of Clinical Cases
IS - 6
ER -