Abstract
Background: Hydra-headed clinical presentations of tuberculosis could be confusing even in immunocompetent, for example pleuro-pericardial effusion with adenitis. From our literature search, this is rare. Case presentation: A 61-year-old clergyman presented with a 3-week history of cough, fever and a 5-day history of progressive dyspnoea. There was associated anaemia, weight loss but no history of drenching night sweat, hemoptysis, exposure to tuberculosis, diabetes or other suggestion of immunosuppression. Examination revealed multiple matted left axillary lymph nodes. Erythrocyte sedimentation rate (ESR) was 70 mm/hr; and negative for Hepatitis B, C and HIV. Chest X-ray showed left lower lung zone homogenous opacity with obliteration of the left cardiac border. Lymph node aspirate and pleural fluid analyses confirmed a tuberculous aetiology. Conclusion: Tuberculous pleuro-pericardial effusion with adenitis occurs in immunocompetent. High index of suspicion in endemic areas as well as early anti-tubercular treatment could be life-saving.
Highlights
Tuberculosis (TB) remains a clinical challenge in developing countries; be its diagnosis, treatment and prevention
Arch Clin Med Case Rep 2017; 1 (2): 45-50 of acute pericarditis and 7% of cardiac tamponade are due to tuberculosis with a mortality rate of 14-40% [2]
We present a case of tuberculous pleuro-pericardial effusion with adenitis in an apparently immunocompetent clergyman
Summary
Tuberculosis (TB) remains a clinical challenge in developing countries; be its diagnosis, treatment and prevention (primary and secondary). Incidence of TB is increasing due to HIV pandemic, multi-drug resistance and excruciating socio-economic melt-down. Asia and Latin America account for 98% of nearly two million deaths resulting from tuberculosis each year [1]. Arch Clin Med Case Rep 2017; 1 (2): 45-50 of acute pericarditis and 7% of cardiac tamponade are due to tuberculosis with a mortality rate of 14-40% [2]. We present a case of tuberculous pleuro-pericardial effusion with adenitis in an apparently immunocompetent clergyman
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