The Diagnostic Challenge of Extrapulmonary Tuberculosis

Figures

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  Figure 1. Pneumopericardium After Tuberculous Esophageal Perforation CT image obtained at the time of tuberculous esophageal perforation. Note the right-sided pleural effusion (asterisk), pericardial thickening (blue arrow) with air within the pericardial space (red arrows). Hilar-enlarged lymph nodes are also present (yellow arrow).

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  Figure 2. Echocardiography of Tuberculous Effusive Pericarditis Echocardiography of the echo-dense, “porridge-like” pericardial mass (red arrow) surrounded by an echolucent pericardial effusion (yellow arrows) from a subcostal view. LV = left ventricle; RA = right atrium; RV = right ventricle.

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  Figure 3. Positron-Emission Tomography of Pericardial Abscesses Positron emission tomography-computed tomography with visualization of large pericardial ovular hypermetabolic structures with a hypodense center (maximum diameter, 62 mm) (red arrows). PET-CT = positron emission tomography-computed tomography.

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  Figure 4. Treatment Effect on Pericardial Abscess Size After 2 and 6 Months of 4-Fold and 2-Fold Tuberculostatic Therapy, Respectively (A) Multifocal pericardial abscesses with a maximal dimension of 65 mm (diameter in yellow) and diffuse pericardial thickening (blue arrow). (B) Treatment effect after 2 months of 4-fold tuberculostatic therapy and high-dose steroids with near resolution of the left-sided and regression of the right-sided pericardial abscess (diameter in yellow). Note the regression of pericardial thickening (blue arrow). (C) Resolution of pericardial collections after a total of 6 months of therapy (red arrow).