Key result
Urgent pericardiocentesis combined with anti-tuberculous therapy, steroids, and remdesivir resulted in marked symptom improvement and resolution of pericardial effusion in a patient with COVID-19.
Why the study?
Pericardial effusion with tamponade has been described with COVID-19, but its association with tuberculosis was not yet known.
Case Report (n=1)
No
This case highlights the rare occurrence of tuberculous pericarditis with tamponade in a patient with COVID-19, emphasizing the need for multimodality imaging and careful diagnostic evaluation.
Tamponade in COVID-19 patients warrants TB pericarditis evaluation; this case leaves any association hypothesis-generating.
Introduction Tuberculous pericarditis is a rare manifestation of tuberculosis infection. COVID-19 pandemic poses a challenge in detecting uncommon disease. Pericardial effusion with tamponade has been described with COVID-19 but the association with tuberculosis is not yet known. Case presentation 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 hemoserous fluid, elevated adenosine deaminase and positive TB PCR. He was started on steroid, anti-tuberculous therapy and Remdesivir with marked improvement of symptoms. Repeat echocardiogram and CT Thorax showed resolution of pericardial fluid and patient was discharged well. Conclusions 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 in COVID-19 (n=1). Pericardiocentesis and medical therapy (anti-tuberculous drugs, steroids, remdesivir) was evaluated on Clinical improvement and resolution of pericardial effusion. Urgent pericardiocentesis combined with anti-tuberculous therapy, steroids, and remdesivir resulted in marked symptom improvement and resolution of pericardial effusion in a patient with COVID-19.
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