A case of cardiac tamponade caused by tuberculous pericarditis

A 71-year-old woman was admitted with a diagnosis of cardiac tamponade. Emergency transthoracic echocardiography showed a large amount of pericardial effusion compressing the whole heart. Pericardiocentesis was performed immediately and nearly 1 liter of hemorrhagic fluid was aspirated. Pathological result of the pericardiocentesis material was benign, acid-resistant bacteria were not found in the pericardial fluid, and bacteria cultures were negative. The only parameter suggesting tuberculous pericarditis was adenosine deaminase activity in the pericardial fluid, which was measured as 76 U/l. With antituberculosis therapy for six months, the patient showed complete improvement; no signs of deterioration were observed and echocardiographic findings were normal.

Keywords: Adenosine deaminase, cardiac tamponade/etiology, echocardiography; pericardial effusion/etiology; pericarditis, tuberculous/diagnosis/therapy