Polymerase chain reaction testing successfully diagnosed atypical, culture-negative tuberculosis as the underlying cause of a massive recurrent pericardial effusion.
Does polymerase chain reaction (PCR) testing improve the diagnosis of tuberculosis in a patient with recurrent pericardial effusion and negative traditional cultures?
PCR is a valuable and rapid diagnostic tool for identifying atypical tuberculosis presentations in patients with recurrent pericardial effusion when traditional cultures are negative.
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A 23 year old army man presented with progressive dyspnoea and was found to have a massive pericardial effusion. Despite extensive investigations the cause remained elusive, until samples were sent for polymerase chain reaction (PCR). This case was unusual for several reasons and is a reminder of the atypical way in which tuberculosis infection can present and how a high index of suspicion should be maintained. It shows the importance of molecular biological advances in providing simple and rapid methods for arriving at the correct diagnosis, by way of nucleic acid probes and polymerase chain reaction. Key points This case was remarkable because: It was an unusual presentation because of the lack of constitutional upset expected with active tuberculosis infection, importantly, the absence of fever and night sweats The patient was HIV seronegative, which is an atypical finding in a patient with these symptoms and with no underlying immunosuppression Despite repeated testing, the culture was negative for tuberculosis It shows the importance of molecular biological advances in providing relatively simple and rapid methods for reaching a correct diagnosis
Rana et al. (Sun,) reported a other. Polymerase chain reaction testing successfully diagnosed atypical, culture-negative tuberculosis as the underlying cause of a massive recurrent pericardial effusion.
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