Saved in:
| Main Author: | |
|---|---|
| Format: | Recurso digital |
| Language: | |
| Published: |
Zenodo
2026
|
| Online Access: | https://doi.org/10.5281/zenodo.19872939 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Table of Contents:
- <p class="font-claude-response-body break-words whitespace-normal leading-[1.7]">A 78-year-old male with a history of hypertension, type 2 diabetes mellitus, and prior transient ischemic attack presented with progressive exertional dyspnea and bilateral ankle edema. He was initially admitted for decompensated heart failure, but his respiratory status deteriorated despite intravenous diuresis, requiring non-invasive positive pressure ventilation. Bedside echocardiography revealed a six-centimeter pericardial effusion without tamponade, and PET-CT demonstrated diffuse pericardial uptake with hypermetabolic hilar and precarinal lymphadenopathy, initially raising concern for malignancy. Pericardiocentesis drained 2.1 liters of hemorrhagic fluid; pericardial fluid culture ultimately confirmed Mycobacterium tuberculosis. The patient was started on RIPE therapy with pyridoxine and a four-week course of corticosteroids, with referral for directly observed therapy and public health notification. Follow-up demonstrated resolution of the effusion without recurrence. This case highlights tuberculous pericarditis as an uncommon but important cause of large hemorrhagic pericardial effusions, the diagnostic value of adjunct testing such as ADA and interferon-gamma when AFB smear and PCR are inconclusive, and the importance of early drainage combined with anti-tuberculous therapy to prevent constrictive pericarditis.</p> <p class="font-claude-response-body break-words whitespace-normal leading-[1.7]"><strong>Keywords:</strong> tuberculous pericarditis; hemorrhagic pericardial effusion; Mycobacterium tuberculosis; RIPE therapy; pericardiocentesis; constrictive pericarditis; case report</p>