Key result
Antituberculosis medications successfully treated an 82-year-old man with tuberculous pericarditis presenting as bilateral pleural effusion, with no fluid re-accumulation on follow-up.
Why the study?
Tuberculous pericarditis progresses through distinct clinical stages, making early diagnosis and treatment of critical clinical significance.
Case Report (n=1)
Bilateral leaking pleural effusion may be an early clinical manifestation of tuberculous pericarditis, which can be diagnosed and monitored using PET/CT.
Supports considering tuberculous etiology in similar effusions; leaves open PET/CT utility pending prospective validation.
BACKGROUND: Tuberculous pericarditis begins with fibrinous and hemorrhagic pericarditis, followed by pericardial effusion, then pericardial hypertrophy, which may turn into subacute or chronic stage, and partly develop into pericarditis. Early diagnosis and treatment have very important clinical significance. CASE SUMMARY: We present a case of an 82-year-old man with a known history of hypertension who was admitted for pleural effusion. CT scan of the chest showed findings of pleural effusion. An echocardiographic study during admission revealed a small amount of pericardial effusion (~1.2 cm in thickness). A whole-body positron emission tomography-computer tomography (PET-CT) scan was then performed and showed a slightly increased fluorodeoxyglucose uptake in the entire pericardium considering tuberculosis. He was started on antituberculosis (TB) medications and tolerated them well. Follow-up echocardiographic study showed no re-accumulation of pleural effusion and pericardial fluid. CONCLUSION: Transudative-exudative pleural effusion may be one of the clinical manifestations of tuberculous pericarditis. (1) Bilateral leaking pleural effusion may be the early clinical manifestation of tuberculous pericarditis; (2) PET/CT in the diagnosis and efficacy evaluation of tuberculous pericarditis is valuable; and (3) the central venous pressure may be an indicator of choice for treatment of tuberculous pericarditis.
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Zhu et al. (2025) conducted a case report in Tuberculous pericarditis (n=1). Antituberculosis (TB) medications was evaluated on Re-accumulation of pleural effusion and pericardial fluid. Antituberculosis medications successfully treated an 82-year-old man with tuberculous pericarditis presenting as bilateral pleural effusion, with no fluid re-accumulation on follow-up.
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