Tuberculous Pericarditis, in an immunocompetent patient. Case Report

Abstract

Tuberculous pericarditis is a rare extrapulmonary manifestation that affects less than 4% of patients with tuberculosis (TB), with high morbidity and mortality in late diagnoses, especially in those immunocompromised patients. Its presentation is nonspecific and the symptomatology derives from the speed of installation of the pericardial effusion, registering fatal cases due to cardiac tamponade. Diagnostic confirmation is obtained with the identification of the mycobacterium in a sample of the pericardium or pericardial fluid, with a high suspicion rate based on additional tests such as quantification of non-stimulated gamma interferon, pericardial lysozyme and adenosine deaminase (ADA) in pericardial fluid. The treatment consist in a combination of antituberculous therapy, pericardial drainage, and corticosteroids as adjuvant. We present the case of a 64-year-old immunocompetent man, frequent smoker in the past, with a high diagnostic suspicion for TB, confirmed with a positive result for ADA (55,8 UI/L) in pericardial fluid, allowing to initiation of adequate treatment with subsequent clinical improvement during follow-up.