Cardiac tamponade as a manifestation of extrapulmonary tuberculosis in β thalassemia major patient

1st International Conference on Tropical Medicine and Infectious Diseases (ICTROMI) Faculty of Medicine Universitas Sumatera Utara

Harahap, S.^1,2 ; Pramudita, A.^1 ; Lusiani^1

Division of Cardiology, Internal Medicine Department, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia^1

Division of Cardiovascular, Internal Medicine Department, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia^2

关键词: After-treatment;    Extrapulmonary tuberculosis;    HIV patients;    Medical emergency;    Mycobacterium tuberculosis;    Patient's heart;    Pericardial effusions;    Real time polymerase chain reactions;   

Others  :  https://iopscience.iop.org/article/10.1088/1755-1315/125/1/012120/pdf
DOI  :  10.1088/1755-1315/125/1/012120

来源: IOP

【 摘 要 】

Cardiac tamponade is a medical emergency condition. Rapid diagnosis and determination of the etiology with epidemiologic consideration may lead to earlier treatment and improved survival. Occasionally, the etiology may be clearly related to a recognized underlying disease, but the possibility of unrelated etiologies should be considered. Pericarditis tuberculosis, a rare manifestation of extrapulmonary tuberculosis in a non-HIV patient, has to be deliberate as one of the etiology, especially in the endemic area. Here, we report a case of 28 years old male with β thalassemia major presented with excessive exertion breathlessness progressing to orthopnea. Sign of cardiac tamponade was identified from echocardiography which showed large pericardial effusion with swinging heart and right atrial systolic collapse. Pericardiocentesis was performed immediately, drained 870 ml of hemorrhagic fluid from inserted pigtail. The patient was treated with the anti-tuberculosis regimen and oral corticosteroid after real-time polymerase chain reaction of Mycobacterium tuberculosis positivity in pericardial fluid. MRI T2 confirmed no haemosiderosis in patient's heart. After treatment, the patient responded well and showed clinical improvement.