Key result
Pericardiocentesis, anti-TB therapy, and Remdesivir led to marked symptom improvement and resolution of pericardial fluid in a patient with COVID-19 and tuberculous pericarditis.
Why the study?
Tuberculous pericarditis is a rare manifestation of tuberculosis infection, and the COVID-19 pandemic poses a challenge in detecting uncommon diseases.
Case Report (n=1)
This case highlights the importance of maintaining a broad differential diagnosis and utilizing multimodality imaging to detect rare concomitant conditions like tuberculous pericarditis in patients presenting with COVID-19.
Warrants vigilance for tuberculous pericarditis in COVID-19 tamponade; leaves open its incidence and optimal screening.
BACKGROUND: Tuberculous pericarditis is a rare manifestation of tuberculosis infection. COVID-19 pandemic poses a challenge in detecting uncommon diseases. CASE SUMMARY: A 47-year-old man was admitted with symptoms of COVID-19 infection. Rapid progression of cardiomegaly on radiograph with clinical deterioration were suggestive of pericardial tamponade. Urgent pericardiocentesis revealed haemoserous fluid, elevated adenosine deaminase, and positive tuberculous (TB) polymerase chain reaction (PCR). He was started on anti-TB therapy and Remdesivir with marked improvement of symptoms. Repeat echocardiogram and CT thorax showed resolution of pericardial fluid, and the patient remained well on discharge. DISCUSSION: This case highlights the difficulty in detecting a concomitant rare but important disease. The development of massive pericardial tamponade acutely is not pathognomonic for COVID-19, and a careful diagnostic process involving multi-modality imaging occurred to arrive at a diagnosis of tuberculosis.
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Wong et al. (2020) conducted a case report in Tuberculous pericarditis with tamponade and COVID-19 (n=1). Pericardiocentesis, anti-TB therapy, and Remdesivir was evaluated on Symptom improvement and resolution of pericardial fluid. Pericardiocentesis, anti-TB therapy, and Remdesivir led to marked symptom improvement and resolution of pericardial fluid in a patient with COVID-19 and tuberculous pericarditis.
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