Tuberculous pericardial effusion after coronary artery bypass graft.
We describe a case of a recurrent pericardial effusion after coronary artery bypass grafting. This was initially considered to be due to post-pericardiotomy syndrome, but was later treated empirically as tuberculosis. After definitive surgery for this condition, pericardial histology and immunohistochemistry confirmed the diagnosis of tubercular pericarditis. At 4-months follow-up, while continuing anti-tuberculous therapy and corticosteroids, the patient showed consistent improvement without further recurrence of his pericardial effusion. Local reactivation of tuberculosis after pericardiotomy has not been previously reported and merits careful consideration in population groups in which tuberculosis is highly endemic.
Tuladhar
Sampurna M
SM
Department of Cardiac Surgery, Hammersmith Hospital, London, United Kingdom.
Noursadeghi
Mahdad
M
Boyle
Joseph J
JJ
Friedland
Jon S
JS
Hornick
Philip
P
D000995:Antitubercular Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004322:Drainage; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D010490:Pericardial Effusion / Q000382:microbiology / Q000628:therapy*; D010491:Pericardial Window Techniques; D010496:Pericardium / Q000382:microbiology / Q000473:pathology; D012008:Recurrence; D014381:Tuberculosis, Cardiovascular / Q000209:etiology* / Q000628:therapy*
D000995:Antitubercular Agents; D005938:Glucocorticoids