| A Case of Acute Tuberculous Pericarditis
with Transient Constrictive Pericarditis for a Short Time |
(Department of Cardiothoracic Surgery, Hachioji
Medical Center of Tokyo Medical University, Tokyo, Japan and The
Second Department of Surgery, Tokyo Medical University*, Tokyo,
Japan)
| Hiromi Yano |
Tatsuhiko Kudou |
Naoki Konagai |
| Mitsunori Maeda |
Masaharu Misaka |
Masataka Matsumoto |
| Shin Ishimaru* |
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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 gdip and plateauh 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.
@Jpn. J. Cardiovasc. Surg. 30: 193-196 (2001) |
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