This case highlights that tuberculosis can present as a pericardial abscess causing impending cardiac tamponade, requiring urgent surgical intervention.
Alerts clinicians to tuberculous pericardial abscess in tamponade; leaves open questions on prevalence and management.
We present the case of a 71-year-old diabetic man who came to us complaining of dyspnea for 1 month. Chest X-ray showed cardiomegaly and bilateral pleural effusion. Echocardiography showed a pericardial cystic mass with external compression of the right ventricle. Because of clinically impending cardiac tamponade, we performed urgent sternotomy and removed the pericardial mass without event. Pathologic examination of the excised pericardial specimen showed caseous necrosis compatible with tuberculosis infection. The patient was put on a 1-year treatment regimen of anti-tuberculosis medication. This case is an important reminder that tuberculosis can occur as a pericardial abscess.
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Lin et al. (2005) studied this question.
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