Tuberculous Pericarditis: A Case Report in South-east Nigeria

Abstract

Tuberculosis is a chronic infection and a common cause of chronic pericardial effusion. Approximately 1-2% of patients with pulmonary tuberculosis (PTB) develop tuberculous pericarditis (TBP) and it is less common in the developed world than in developing countries where active tuberculosis is endemic. In these countries with high endemicity, TBP is the most common form of pericarditis and is often associated with HIV. The clinical picture is usually that of a chronic systemic illness in a patient with pericardial effusion. The index case is that of a 24 year old male, who had presented to our medical outpatient clinic with a history of cough and chest pain of 9 and 2 days duration respectively. Diagnosis was made following echocardiography, electrocardiography (ECG), Chest X-ray (CXR) and culture findings which showed features in keeping with tuberculous pericarditis. His clinical condition improved significantly following pericardiocentesis and TB treatment was subsequently instituted. He was discharged for outpatient follow-up 5 days after pericardiocentesis. TBP can be difficult to diagnose and often goes undetected especially in resource poor countries. Accurate and early diagnosis is important as it is a dangerous disease if left untreated.