PDF(Pubmed)
Abstract：
Pericarditis can be a common complication of tuberculosis (TB) in developing countries like India. It is associated with fever, fatigue, and weight loss and can often be accompanied by shortness of breath and chest pain. Other common causes of pericardial effusion include malignancy, renal failure, autoimmune disease, and viral and bacterial infections. When the pericardial fluid is bloody, TB is likely to be present in developing countries. It can often get complicated with cardiac tamponade, which has a high mortality rate. We present a case of a 55-year-old female with no co-morbidities who presented with shortness of breath, fatigue for two weeks, and chest pain for one week. She had no history of fever, chills, or rigour, and no history of TB contact. Clinical examination revealed low blood pressure with raised jugular venous pressure (JVP). Her electrocardiography (ECG) showed sinus tachycardia with a low-voltage complex. Echocardiography (ECHO) showed a large pericardial effusion, compromising ventricular function. We performed pericardiocentesis, drained 1.4 L of bloody fluid, and sent the pericardial fluid for analysis. Pericardial fluid adenosine deaminase (ADA) and cartridge-based nucleic acid amplification testing (CBNAAT) came positive for Mycobacterium TB. The patient was started on anti-tubercular treatment (ATT) and broad-spectrum antibiotics with drainage. Other routine investigations and autoimmune immune workups were normal. The patient also developed ATT-induced hepatitis, for which modified ATT was initiated. The patient improved clinically and symptomatically, was discharged, and was advised to follow up in the outpatient department (OPD).
摘要：
在印度等发展中国家，心包炎可能是结核病（TB）的常见并发症。它与发烧有关，疲劳,和体重减轻，通常会伴有呼吸急促和胸痛。心包积液的其他常见原因包括恶性肿瘤，肾功能衰竭,自身免疫性疾病，以及病毒和细菌感染。当心包液有血迹时,结核病很可能出现在发展中国家。心脏填塞通常会变得复杂，死亡率很高。我们介绍了一个55岁的女性，没有合并症，出现呼吸急促，疲劳两周，胸痛一周。她没有发烧史,发冷,或者严谨，没有结核病接触史。临床检查显示低血压，颈静脉压（JVP）升高。她的心电图（ECG）显示窦性心动过速伴有低电压复合物。超声心动图（ECHO）显示大量心包积液，损害心室功能。我们做了心包穿刺术,排出1.4L的血液，把心包液送去分析.心包液腺苷脱氨酶（ADA）和基于药筒的核酸扩增测试（CBNAAT）对结核分枝杆菌呈阳性。患者开始接受抗结核治疗（ATT）和广谱抗生素引流。其他常规检查和自身免疫检查均正常。患者还患上了ATT诱导的肝炎，已启动修改的ATT。患者在临床和症状上有所改善，已出院,并建议在门诊部（OPD）进行随访。
