Tuberculous pericardial effusion
Emaciated male with dyspnea.
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Ultrasound abdomen was requested for this patient, on which hepatomegaly with prominent dilated hepatic veins and IVC were noted.
Based on these findings a provisional diagnosis of tubercular pericardial effusion was given.
Pericardial effusion is a common manifestation of tubercular pericardial disease, which presents with symptoms such as dyspnea and cough.
Thickening of pericardium and fibrinous strands suggest the tubercular etiology.
Chest x-ray of this patient showed a globular heart. Pericardiocentesis was done and showed elevated levels of ADA and LDH, and the diagnosis was confirmed with PCR.
- Reuter H, Burgess LJ, Louw VJ et-al. The management of tuberculous pericardial effusion: experience in 233 consecutive patients. Cardiovasc J S Afr. 2007;18 (1): 20-5. Pubmed citation
- Mayosi BM, Burgess LJ, Doubell AF. Tuberculous pericarditis. Circulation. 2005;112 (23): 3608-16. Circulation (full text) - doi:10.1161/CIRCULATIONAHA.105.543066 - Pubmed citation