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Tuberculosis myocarditis: a case report
S S Danbauchi1, V I Odigie, A H Rafindadi
1Departments of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
The Nigerian Postgraduate Medical Journal
|April 2, 2002
Summary
Tuberculosis can cause constrictive pericarditis and cardiac failure, even with negative initial TB tests. Myocardial biopsy proved crucial for diagnosing tuberculous myocarditis in this case.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Tuberculosis (TB) can present with extrapulmonary manifestations, including cardiac involvement.
- Constrictive pericarditis is a potential complication of pericardial TB.
- Diagnosis of TB can be challenging in atypical presentations.
Observation:
- A 35-year-old man presented with prolonged fever, weight loss, night sweats, and cardiac failure symptoms.
- Physical examination revealed wasting, edema, pleural effusions, and signs of constrictive pericarditis.
- Initial investigations including HIV and sputum AFB smears were negative.
Findings:
- Electrocardiography showed global low voltages.
- Echocardiography demonstrated global myocardial hypokinesia.
- Histology of pericardial and pleural tissues showed non-specific inflammation, but myocardial biopsy revealed granulomatous changes consistent with tuberculous myocarditis.
Implications:
- Myocardial biopsy can be a valuable diagnostic tool for tuberculous myocarditis, especially when other methods are inconclusive.
- This case highlights the importance of considering TB in unexplained constrictive pericarditis and cardiac dysfunction.
- Early and accurate diagnosis through methods like myocardial biopsy can guide appropriate treatment for tuberculous cardiac disease.