ARYA Atherosclerosis Journal

Benign Tuberculous Constrictive Pericarditis: A Case of Complete Resolution with Empirical Antimicrobial Treatment

Document Type : Case Report

Authors

Seyedeh Mahnaz Mirbod 1
Zahra Azamian-Jazi 2
Zahra Soleimani 3
Azam Soleimani 4

1 Department of Cardiology,Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

10.22122/arya.2022.11793.2445
Abstract
Tuberculous (TB) pericarditis is a well-known manifestation of tuberculosis, particularly in endemic regions. The progression to constrictive pericarditis, while under anti-tuberculosis treatment, is reported to be as high as 30%. This report presents a case of a 56-year-old female patient who complained of cough, pleuritic chest pain, night sweats, and fever, followed by orthopnea, dyspnea, and peripheral edema. Transthoracic echocardiography revealed the early stages of constrictive pericarditis and a small pericardial effusion. Chest computed tomography (CT) showed a thickened pericardium, small pericardial and pleural effusions, and multiple mediastinal lymphadenopathies. Due to a high suspicion of tuberculous pericarditis, the patient was administered empirical anti-TB treatment. A follow-up after two months showed complete resolution of symptoms and echocardiographic findings. Empirical antimicrobial treatment in endemic areas is a well-established strategy for managing tuberculous infection and proved successful in this patient. The early presentation and the significant improvement in signs and symptoms following the medical anti-TB regimen, without the need for pericardiectomy, were unique aspects of this case.
 

Keywords

Constrictive Pericarditis
Tuberculosis
Empirical Antimicrobial Treatment
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ARYA Atherosclerosis Journal
Volume 19, Issue 3
May 2023
Pages 54-58

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