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Milky heart: A rare case of tuberculous chylopericardium managed conservatively
Kevin Paul DA Enriquez1, John Christopher A Pilapil1, Bynlee Stuart Go2
1Division of Cardiovascular Medicine, Department of Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines.
Abstract:
IntroductionTuberculosis (TB) is a rare cause of chylopericardium. Optimal management remains unclear.Methods/ResultsA 30-year-old Filipino male presented with recurrent massive pericardial effusions, with pericardiostomy revealing chylopericardium. Microbiologic TB studies were negative, and other etiologies were excluded. Pericardial fluid adenosine deaminase was elevated; anti-TB regimen was initiated, leading to resolution.DiscussionThere is no consensus about the optimal management of TB chylopericardium. Adenosine deaminase represents a useful test to diagnose TB in inflammatory, lymphocyte-predominant effusions, especially when other tests are negative. Failed conservative management merits more invasive approaches.ConclusionWhile data remain lacking, this case suggests that TB chylopericardium responds to anti-TB therapy.
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