Empirical anti-tuberculous therapy, corticosteroids, and pericardiectomy led to significant clinical improvement within 6 weeks in a 21-year-old patient with suspected systemic and cardiac TB.
Case Report (n=1)
Advanced multimodal imaging, particularly cardiac magnetic resonance, is crucial for diagnosing and guiding treatment in complex cases of culture-negative systemic tuberculosis with cardiac involvement.
Tuberculosis (TB) is a major public health challenge, primarily affecting the lungs. However, it can disseminate to any organ system, including the cardiovascular system. Among cardiac structures, the pericardium is the most commonly affected, often leading to constrictive pericarditis, whereas myocarditis remains rare. The clinical presentation of cardiac TB is heterogeneous and is frequently associated with extra cardiac manifestations, complicating the diagnostic process, particularly in the absence of definitive microbiological confirmation. In this context, advanced multimodal imaging is essential to improve diagnostic accuracy. We present a complex case of systemic TB manifesting as chronic constrictive pericarditis, myocarditis, pleuritis, chorioretinitis, and spondylodiscitis with a psoas abscess. A 21-year-old patient was admitted with dyspnea, acute chest pain, progressive vision declines and persistent lower back pain. Imaging, notably cardiac magnetic resonance, strongly suggested myopericardial TB associated with systemic involvement. Nonetheless, microbiological and histopathological tests for TB were negative. Given the high clinical suspicion of TB and the lack of other plausible causes, anti-tuberculous therapy was initiated along with corticosteroids and heart failure regimen. Pericardiectomy was subsequently performed. The patient demonstrated significant improvement within 6 weeks, further supporting the diagnosis of TB. Considering the potentially life-threatening complications of cardiac TB, a high index of clinical suspicion, along with a comprehensive multimodal imaging approach, is essential for early diagnosis, timely intervention, and improved patient outcomes.
Jabri et al. (Fri,) conducted a case report in Systemic tuberculosis with cardiac involvement (n=1). Anti-tuberculous therapy, corticosteroids, heart failure regimen, and pericardiectomy was evaluated on Clinical improvement. Empirical anti-tuberculous therapy, corticosteroids, and pericardiectomy led to significant clinical improvement within 6 weeks in a 21-year-old patient with suspected systemic and cardiac TB.