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A CASE OF TUBERCULOUS PERICARDIAL EFFUSION

Primasari Diah I.L, Subakir, Desvita Sari

Departement of Clinical Microbiology,


Faculty of Medicine Diponegoro University - Dr. Kariadi Hospital Semarang
Email : orvink3nzie@yahoo.com

ABSTRACT

Tuberculosis accounts for up to 4% acute pericarditis and 7% of cases of cardiac tamponade. The

clinical presentations are varied and non-specific, which may inhibit or delay diagnostic definitions

resulting in late complications such as constrictive pericarditis and increased mortality. The finding

of Mycobacterium tuberculosis in pericardial fluid culture confirms the diagnosis.

Case presentation :

A 25-year-old male patient had a fever that disappeared for 3 months accompanied by an

unproductive dry cough since a month. There is no history of tuberculosis, diabetes, or

immunosuppression. On examination, he had a temperature fever of 38.3C, pulse 96 / min, blood

pressure 120/85 mmHg, and respiratory rate 22 / min. Jugular venous pulse was raised and on

auscultation, the heart sounds were muffled and associated with a pericardial rub.

Laboratory investigations showed Hb 10.8 g / dl; WBC 12.600 / mm3 with 60% polymorph,

lymphocyte 37%, 2% eosinophils and monocytes 1%, platelet count 1x10 / uL. Chest x-rays

showed left basal consolidation with effusion along with cardiomegaly. The Acid Fast Bacilli

(AFB) results were positive from pericardium fluid smear, Loewenstein Jensen culture and Gen-

Expert.
Conclution :

The diagnosis of pericardial tuberculosis in this patient was established with clinical cardiac

tamponade, chest X-ray, AFB staining, culture of Loewenstein Jensen and Gen-Expert

Keyword :

Tuberculous pericardial effusion, Gen-Expert,adult