Tuberculous pericarditis treated with steroid in a dialysis patient

BMJ Case Rep. 2017 Aug 1:2017:bcr2017220562. doi: 10.1136/bcr-2017-220562.

Abstract

Mycobacterium tuberculosis has spread worldwide and its mortality rate had been very high. The prevention technology and antituberculosis (TB) chemotherapy has improved its prognosis. However, immunocompromised patients, such as those who had HIV infection, older age and on haemodialysis, are still at high risk of TB infection. TB pericarditis is a common cause of constrictive pericarditis and its mortality remains high. Early diagnosis and initiation of appropriate therapy are critical to improve mortality. Additionally, detection of an elevation in the adenosine deaminase level in pericardial effusion is reported to be useful. We report the case of an immunocompromised patient with TB pericarditis, and steroid therapy could prevent him from progressing to constrictive pericarditis. The adenosine deaminase value of pericardial effusion was so helpful that we could promptly make clinical and therapeutic decisions.

Keywords: heart failure; tb and other respiratory infections.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Pericarditis, Tuberculous / drug therapy*
  • Renal Dialysis
  • Steroids / therapeutic use*
  • Treatment Outcome

Substances

  • Antitubercular Agents
  • Steroids