A Case of Acute Tuberculous Pericarditis with Transient Constrictive Pericarditis for a Short Time.
10.4326/jjcvs.30.193
- VernacularTitle:短期間に収縮性心膜炎に移行した急性結核性心膜炎の１例
- Author:
Hiromi Yano
;
Tatsuhiko Kudou
;
Naoki Konagai
;
Mitsunori Maeda
;
Masaharu Misaka
;
Masataka Matsumoto
;
Shin Ishimaru
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2001;30(4):193-196
- CountryJapan
- Language:Japanese
-
Abstract:
A 32-year-old man was admitted with dyspnea on exertion and a prolonged common cold. Swelling of mediastinal lymph nodes, pericardial thickening and pleural effusion were detected by chest CT. Mycobacterial culture of sputa and pleural effusion were negative. Serum adenosine deaminase (ADA) activity was normal. A tuberculin test showed a positive reaction (20×15mm). Viral antibody titers (Coxsackie A9, echo 3, influenza B) were negative. Ten days after admission, the patient had pyrexia and low cardiac output symptoms. Right ventricular pressure curve cardiac catherterization showed a“dip and plateau”pattern which indicated constrictive pericarditis. We performed subtotal pericardiectomy (from the right phrenic nerve to the left phrenic nerve). Pathological examination of pericardium showed Langerhans' giant cell infiltration and caseous necrosis which could be diagnosed as tuberculosis. Although the patient had transient pleural effusion, symptoms disappeared postoperatively. At present there are no signs of recurrent infection.
