Background:
Recurrent episodes of isolated pericardial effusion due to tuberculosis,
leading to reduced Left Ventricle Ejection Fraction (LVEF), are uncommon.
Methods:
This is a case report of a previously healthy 32-years old male with tuberculous induced
pericardial effusion as isolated manifestation. The only known exposure of tuberculosis was a
brother with whom the patient did not have physical contact during the last year. The pericardial
effusion repeatedly appeared after being drained a total of three times. Due to recurrent episodes of
pericardial effusion, severe thickening of the pericardium, pericardial adherences and increasing
affection on the heart, pericardiectomy was ultimately performed.
Results:
Biochemical examination, chest X-ray, computed tomography of thorax and abdomen and
cytology report did not reveal any signs of malignancy, connective tissue disease or other infections
including extra-pulmonary/pulmonary tuberculosis. However, the pericardial biopsy was Polymerase
Chain Reaction positive (PCR) for tuberculosis DNA and showed granulomatous inflammation
with necrosis. After 6 months anti-tuberculous therapy, biochemical parameters, LVEF
and the clinical condition of the patient were normalized.
Conclusion:
Tuberculosis can be difficult to diagnose when it only manifests as pericardial effusion
especially if the time for exposure is long before the appearance of symptoms and admission.
Activated Macrophage and Granulomatous Inflammation
