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A Complex Case: Tubercular Pleural Effusion, Infarct, and Multisystem Involvement.
Milly M Tadigiri1, Arub Imam2, Rishab J Martins1
1Department of Surgery, Bharati Vidyapeeth Hospital, Pune, IND.
Cureus
|October 4, 2024
Summary
Tuberculous pleural effusion in a patient with multiple comorbidities presented diagnostic challenges. This case highlights the need for a multidisciplinary approach in managing complex tuberculosis cases.
Area of Science:
- Pulmonology
- Neurology
- Infectious Diseases
Background:
- Tuberculous pleural effusion is a common form of extrapulmonary tuberculosis.
- Managing patients with multiple comorbidities presents unique clinical challenges.
Observation:
- A 58-year-old female with diabetes, hypertension, and other conditions presented with symptoms of tuberculous pleural effusion.
- She subsequently developed neurological symptoms consistent with a stroke.
Findings:
- Tuberculous pleural effusion was confirmed via pleural fluid analysis.
- A left frontal lobe lacunar infarct was diagnosed using CT and MRI, with cerebrospinal fluid negative for tuberculosis.
- Electrolytes (hypocalcemia, hyponatremia) were corrected, and antiplatelet therapy was initiated for the infarct.
Implications:
- This case underscores the diagnostic and management complexities of tuberculous pleural effusion in patients with significant comorbidities.
- Emphasizes the importance of a timely, comprehensive, and multidisciplinary approach for optimal patient outcomes.
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