Key result
A 31-year-old male with chronic purulent pericarditis, likely of tuberculous origin, underwent pericardiectomy but died one hour post-surgery due to anesthesia complications.
Case Report (n=1)
This case highlights the diagnostic challenges of purulent pericarditis presenting with massive pleural effusion and supports empirical anti-tuberculosis treatment in resource-limited, TB-endemic settings.
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Anesthesia complications can prove fatal in pericardiectomy for tuberculous pericarditis; this case leaves open optimal perioperative strategies.
Purulent pericarditis is an infection of the pericardial space that produces pus that is found on gross examination of the pericardial sac or on the tissue microscopy. In this case report, we will discuss a 31-year-old male who presented with a chief complaint of low-grade fevers, dry cough and difficulty breathing for about two weeks which preceded after removing of dental also two weeks prior. He was admitted and treated as COVID-19 in the isolation ward, he later developed cardiac tamponade and during pericardiocentesis thick pus was discharged. Pus culture and Gene Xpert tests were all negative. After his condition improved, the patient was transferred to the general ward with the pericardial window still discharging pus. Pericardiectomy was chosen as definitive management. The key takeaway in this report is that Empirical treatment with RHZE (rifampin, isoniazid, pyrazinamide, and ethambutol) in resource-limited settings is recommended due to difficulty in identifying the exact cause at a required moment.
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Vara et al. (2022) conducted a case report in Chronic purulent pericarditis (n=1). Pericardiectomy and empirical RHZE was evaluated on Patient outcome. A 31-year-old male with chronic purulent pericarditis, likely of tuberculous origin, underwent pericardiectomy but died one hour post-surgery due to anesthesia complications.
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