Tuberculous pericarditis associated with hoarseness of voice due to left recurrent laryngeal nerve paralysis.
A 16-years-old Egyptian girl presented with massive pericardial effusion, fever, weight loss and hoarseness of voice. Laryngoscopy showed left vocal cord paralysis. Chest CT revealed pericardial effusion, amalgamated mediastinal lymph nodes and clear lung fields. Pericardial fluid analysis revealed a lymphocytic exudate with high adenosine deaminase enzyme level, negative stains and cultures for bacteria and fungi. Despite a negative nucleic acid test for tuberculosis; antituberculous and corticosteroids therapies resulted in resolution of pericardial effusion after 3 weeks but hoarseness of voice persisted. Few cases of vocal cord paralysis with tuberculous mediastinal lymphadenopathy were reported in English literature.
Department of Internal Medicine, Kasr Elaini Hosp-Cairo University, Cairo, Egypt.
Ragai
R
Fouda
Hussam
H
Ammar
Ramy
R
Edward
Waleed M
WM
Alnabawy
Iman M
IM
Fouda
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006685:Hoarseness / Q000209:etiology*; D006801:Humans; D007823:Laryngeal Nerves; D008206:Lymphatic Diseases / Q000150:complications* / Q000382:microbiology; D008482:Mediastinum; D010490:Pericardial Effusion / Q000209:etiology; D010495:Pericarditis, Tuberculous / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000209:etiology*
D000305:Adrenal Cortex Hormones; D000995:Antitubercular Agents