Department of General Practice and Emergency Medicine, Dhulikhel Hospital, Dhulikhel, Nepal.
Department of Internal Medicine, Mount Sinai Hospital Medical Center of Chicago, Chicago, USA.
J Nepal Health Res Counc. 2021 Jan 22;18(4):795-797. doi: 10.33314/jnhrc.v18i4.2305.
Pericardial effusion is an uncommon extra-pulmonary manifestation of tuberculosis, tamponade being even rarer. Here, a 14-year female presented with cough, chest pain and fever. She had raised jugular venous pressure, hypotension, and muffled heart sound, suggestive of cardiac tamponade, confirmed by echocardiogram. She underwent pericardiocentesis with continuous pericardial fluid drainage. Her jugular venous pressure normalized after the aspiration. The high adenosine deaminase level in pericardial fluid analysis was suggestive of tuberculosis for which she was treated with antitubercular therapy and steroid. This case highlights the importance of adenosine deaminase for diagnosing the etiology of a rare presentation. Keywords: Adenosine deaminase; echocardiography; pericardial effusion; tamponade; tuberculosis.
心包积液是结核病少见的肺外表现，心包填塞更为罕见。本例为 14 岁女性，表现为咳嗽、胸痛和发热。她颈静脉压升高、低血压、心音低沉，提示心包填塞，超声心动图证实了这一点。她接受了心包穿刺术和持续的心包液引流。抽吸后颈静脉压恢复正常。心包液分析中腺苷脱氨酶水平升高提示为结核，因此她接受了抗结核治疗和激素治疗。本病例强调了腺苷脱氨酶在诊断罕见表现病因中的重要性。关键词：腺苷脱氨酶；超声心动图；心包积液；填塞；结核。
