Tuladhar Sampurna M, Noursadeghi Mahdad, Boyle Joseph J, Friedland Jon S, Hornick Philip
Department of Cardiac Surgery, Hammersmith Hospital, London, United Kingdom.
Ann Thorac Surg. 2006 Oct;82(4):1519-21. doi: 10.1016/j.athoracsur.2006.02.059.
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.
我们描述了一例冠状动脉搭桥术后复发性心包积液的病例。该病例最初被认为是心包切开术后综合征所致，但后来根据经验按结核病进行治疗。针对该病症进行确定性手术后，心包组织学和免疫组织化学检查确诊为结核性心包炎。在4个月的随访中，患者在继续抗结核治疗和使用皮质类固醇的情况下，病情持续改善，心包积液未再复发。心包切开术后结核局部复发此前未见报道，在结核病高度流行的人群中值得仔细考虑。
