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Tuberculous pericarditis in a child

J B Coulter¹, K Walsh, S J King

¹Department of Child Health, Royal Liverpool Children's Hospital, Alder Hey, UK.

The Journal of Infection

|March 1, 1996

Summary

Tuberculous pericarditis with cardiac tamponade in a 14-year-old boy was diagnosed via pericardial fluid culture. Treatment with anti-tuberculous chemotherapy and corticosteroids led to an excellent recovery.

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Area of Science:

Pediatric Cardiology
Infectious Diseases
Pulmonology

Background:

Tuberculous pericarditis is a significant cause of cardiac tamponade, particularly in endemic regions.
Early diagnosis and treatment are crucial for favorable outcomes in pediatric cases.

Observation:

A 14-year-old male presented with symptoms of tuberculous pericarditis and cardiac tamponade.
Pericardial aspirate culture confirmed Mycobacterium tuberculosis.
Acid-fast bacilli were identified in induced sputum, despite the absence of a cough.

Findings:

Computed tomography revealed enlarged mediastinal lymph nodes, while chest X-ray showed no pulmonary tuberculosis.
The patient demonstrated a robust clinical response to a regimen of anti-tuberculous chemotherapy and corticosteroids.

Implications:

This case highlights the importance of considering tuberculous pericarditis in pediatric patients with unexplained pericardial effusion and tamponade.
Diagnostic approaches should include sputum induction and imaging modalities like CT scans for mediastinal lymphadenopathy.
Prompt initiation of appropriate medical therapy is associated with excellent patient outcomes.

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