Constrictive Pericarditis: A Late Complication of Tuberculosis

Abstract

Tuberculous pericarditis is a rare condition, with significant severity, in patients infected with Mycobacterium tuberculosis or in a state of relapse of the disease. An initial diagnosis of symptoms is fundamentally important for the proper treatment of the patient. The clinical case presents a 37-year-old male patient, who complained of dyspnea and progressive chest pain for 20 days. Patient had undergone pulmonary tuberculosis treatment and surgical procedure 5 months ago due to complication of the disease. According to clinic and patient’s previous history, tuberculous pericarditis was suspected. In this condition, the pericardium can be affected by Koch’s bacillus through hematogenous dissemination during the course of endogenous reactivation of pulmonary focus or by direct extension of the disease in the lung, pleura, and tracheobronchial lymph nodes into the pericardial cavity. Proof of diagnosis is performed by demonstration of tubercle bacilli in pericardial material, through pericardial culture or pericardial fluid biopsy. The echocardiogram is the most effective diagnostic test for the disease. Pericardial tuberculosis has a variable presentation that makes it difficult to diagnose and may delay the start of adequate treatment. Rapid institution of the clinical suspicion and accomplishment of the diagnostic tests are definitive for a better prognosis of the patient.