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Case Reports
. 2025 Apr 20;17(4):e82632.
doi: 10.7759/cureus.82632. eCollection 2025 Apr.

Disseminated Tuberculosis With Pericardial Effusion and Early Tamponade: A Case Report

Usamah Al-Anbagi  1 , Ali A Alkeldi  2 , Claret Charles Isabirye  3 , Abdulqadir J Nashwan  4
Affiliations
Case Reports

Disseminated Tuberculosis With Pericardial Effusion and Early Tamponade: A Case Report

Usamah Al-Anbagi et al. Cureus. .

Abstract

Tuberculous pericarditis is a rare but life-threatening complication of tuberculosis (TB), often presenting with nonspecific symptoms and leading to delayed diagnosis. This case report describes a 26-year-old male with disseminated TB involving the pericardium, pleura, and mediastinal lymph nodes, complicated by early cardiac tamponade. Despite the presence of tamponade physiology, the patient was successfully managed with anti-TB therapy and corticosteroids without invasive intervention. Diagnostic challenges, including the role of imaging, fluid analysis, and molecular testing, are discussed. The case highlights the importance of early diagnosis, timely initiation of anti-TB therapy, and the potential for non-interventional management in select cases. Clinical improvement and resolution of tamponade physiology on follow-up echocardiography underscore the efficacy of medical therapy in preventing complications such as constrictive pericarditis. This report emphasizes the need for a high index of suspicion in TB-endemic regions and the value of individualized treatment approaches.

Keywords: anti tuberculosis therapy; cardiac tamponade; mycobacterium tuberculosis (mtb); pericardial effusion; pericardiocentesis; pericarditis; steroid.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. IRB at the Medical Research Center in Hamad Medical Corporation issued approval MRC-04-25-302. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Chest X-ray (PA view)
The red arrows showed bilateral pleural effusion, the blue arrow revealed cardiomegaly with pericardial effusion. PA: posteroanterior
Figure 2
Figure 2. Axial CT thorax
The red arrows showed bilateral pleural effusion, the blue arrow revealed cardiomegaly with pericardial effusion.
Figure 3
Figure 3. Chest X-ray (PA view)
CXR revealed improvement in both pleural and pericardial effusion. PA: posteroanterior
See this image and copyright information in PMC

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