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Tuberculous pericarditis-a silent and challenging disease: A case report
Oscar David Lucero1, Marlon Mauricio Bustos2, Darwin Jhoan Ariza Rodríguez3
1Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá 110231, Colombia. oscardavidlucero21@gmail.com.
World Journal of Clinical Cases
|March 23, 2022
Summary
Tuberculous pericarditis (TP) diagnosis is confirmed by analyzing pericardial fluid. Early detection and treatment of TP improve patient outcomes and prevent complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Tuberculous pericarditis (TP) is a significant health concern in tuberculosis-endemic regions.
- Approximately 1-2% of patients with pulmonary tuberculosis develop TP, posing a diagnostic challenge.
Observation:
- A 49-year-old woman presented with dyspnea, chest pain, and cough, indicative of potential cardiac or pulmonary issues.
- Physical examination revealed muffled heart sounds, and diagnostic tests showed low-voltage ECG complexes and a large pericardial effusion.
Findings:
- Pericardial fluid analysis demonstrated elevated adenosine deaminase levels and the presence of acid-fast bacilli via Ziehl-Neelsen staining.
- Polymerase chain reaction (PCR) confirmed Mycobacterium tuberculosis in the pericardial fluid, establishing the diagnosis of TP.
- The patient responded well to a four-drug regimen, with resolution of fever and chest pain within a week.
Implications:
- Confirming TP diagnosis through pericardial fluid analysis or biopsy is crucial for effective management.
- Timely diagnosis and initiation of treatment for TP are essential to prevent severe complications and improve patient prognosis.
