Oummou S
Center of the hospital campus Mohammed VI, Morocco
Title: " Pericardial effusion revealing multifocal tuberculosis in an immunocompetent: about a case"
Biography
Biography: Oummou S
Abstract
Introduction: Tuberculosis is an endemic disease in developing countries and disadvantaged communities. The mode of revelation remains mainly the pulmonary involvement; The association of pericardial and neurological localization is extremely rare with a high mortality rate.
Observation: 25-year-old patient with no specific pathological ATCDs and no tuberculosis counts admitted to the emergency department for exercise dyspnea evolving during 1 month becoming stage IV with positional chest pain, productive cough with expectorations, asthenia, emaciation and febrile sensations . The clinical examination had objectified a deafening of the noises of the heart. The ECG was without abnormality with cardiomegaly on the thorax radio without obvious parenchymal abnormality. The cardiac ultrasound showed a pericardial effusion of great abundance with signs of tamponade. The patient underwent a pericardial puncture bringing a sero-hematic fluid. The study of this fluid was predominantly lymphocytic exudative with a high level of LDH. The hemogram had demonstrated lymphopenia at 700 / mm 3, hyponatraemia at 131 mmol / l at the ionogram, BK sputum was negative, IDR not done with a positive quantifier at 6.63. During his hospitalization the patient presented febrile partial convulsions of the left hemicorps. Cerebral imaging was performed (cerebral scan and MRI) demonstrating an appearance of cerebral tuberculoma. Antibacillary treatment was started with a good evolution.
Conclusion: Tuberculosis remains the most frequent aetiology which must be evoked before any pericardial effusion. Multifocal tuberculosis is usually severe and potentially life-threatening. The earlier the anti-tuberculosis treatment begins, the better the prognosis.