Constrictive pericarditis due to extrapulmonary tuberculosis: A case report
DOI:
https://doi.org/10.26871/killkana_salud.v9i3.1679Keywords:
Mycobacterium tuberculosis, Pericarditis, Pericardiectomy, TuberculosisAbstract
Introduction: Constrictive pericarditis due to extrapulmonary tuberculosis is considered a rare pathology worldwide. It is silent and its diagnosis is based on clinical evaluation, cardiac imaging and histological and bacteriological confirmation of pericardial tissue. Clinical case: We present the case of a 67-year-old male patient with a history of hepatitis B and ascites, who was initially evaluated by the gastroenterology service, where a diagnostic paracentesis was performed with extraction of 6 liters of ascitic fluid, without finding an apparent cause. Due to the persistence of symptoms, a transthoracic echocardiogram was requested, which showed signs compatible with constrictive pericarditis: septal bounce, E/A ratio of 1.3, septal e´ of 14.1 cm/s, lateral e´ of 8.70 cm/s (mitral annulus reversus), and parietal pericardial thickening of 0.8 cm, so the patient was admitted for surgical resolution by pericardiectomy. Bacteriological examination of the pericardial tissue confirmed infection by Mycobacterium tuberculosis, and the histopathological study showed chronic non-caseating granulomatous pericarditis. Finally, antituberculosis treatment was started, showing significant clinical improvement. Conclusion: Constrictive pericarditis due to Mycobacterium tuberculosis represents a rare but significant form of the disease. In this case, a combination of imaging, bacteriological, and histological techniques was required to arrive at a diagnosis. Comprehensive management with surgery and specific antituberculosis treatment allows for significant clinical improvement.
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