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Twenty four patients underwent pericardectomy for constrictive pericarditis. There were 2 operative deaths. Tuberculosis was the aetiological factor in 20 patients and a post surgical aetiology was found in 2 patients. The aetiology remained unclear in 2 patients.
A case of tuberculous pericarditis successfully managed with medical treatment alone was reported. A 78-year-old male was admitted because of cough, dyspnea and fever. Chest X-P and echocardiogram revealed massive pericardial effusion. His clinical symptoms and signs suggested cardiac tamponade. Mycobacterium tuberculosis was detected from pericardial fluid. ADA activity in pericardial fluid was high. Thoracic CT scan showed tracheobronchial, pretracheal, paratracheal and superior mediastinal lymph-node swelling. The diagnosis of tuberculous pericarditis was confirmed. Anti-tuberculous therapy consisting of INH, RFP, EB in combination with prednisolone was started. One month later pericardial effusion was controlled and six months later he was in good clinical condition without surgical treatment.
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A case of bilateral femoral mycotic aneurysms resulting from bacille Calmette-Guérin vaccine, is reported in a 74-year-old man treated by intravesical immunotherapy. The diagnosis was made after histologic and bacteriologic examinations and biochemical analysis of the acid-fast-baccilli. Treatment consisted of resection and replacement of the femoral arteries, with an expanded polytetrafluoroethylene graft on the left side and a saphenous vein graft on the right side. After surgery the patient was treated with antituberculous chemotherapy for 1 year. The patient was doing well 18 months later.
We report a case of a 22 year-old drug addict man with overt heart failure and cardiomegaly. The patient had no prior history of tuberculosis and not clinical features to suggest this diagnosis. Tuberculosis myocarditis was found at the necropsy. It is important to point out the frequency of this pathology, the uncommon clinical presentation of this case; as well as the lack of immunologic response to the tuberculous bacillus.
A case of specific tuberculous pericarditis is described. A short clinical and etiological classification of pericarditis is given. There are so many new forms of pericarditis today, like autoimmune, postirradiation, drug induced, etc. Specific tuberculous pericarditis is rarely registered today. One must intend to specify TB pericarditis almost if pericardial effusion is present. Pericardial punction is of much help in the diagnosis and treatment of pericardial effusion. Steroid therapy is very important in prevention of forming pericardial adhesions.
A tuberculous pseudo-aneurysm of the thoracic descending aorta was found in a 57 year-old female with haemoptysis three months after successful chemotherapy for a miliary tuberculosis. After aortic angiography, the aneurysm was resected and the aorta was repaired with a Dacron prosthetic graft. The patient is doing well one year after the operation.
An 18-year old woman was admitted to hospital with signs of right heart failure and atrial tachycardia. Ultrasounds showed a tumoral mass in the tricuspid valve. Post-mortem examination revealed that the mass was a tuberculoma obstructing the tricuspid orifice. The exceptional character of this case is emphasized: lesions of the heart have been found in less than 0.3 p. 100 of tuberculous patients autopsied. The different anatomical aspects of tuberculosis of the heart are mentioned, and it is suggested that echocardiography should be performed systematically in all patients with severe, disseminated tuberculosis. Tuberculoma of the heart should figure on the list of intraparietal and intraluminal masses visualized at echocardiography.
A 25-year old female patient was admitted to hospital for respiratory failure with pulmonary miliary. Subsequently, clinical signs of pericardial tamponade developed. Echocardiography showed a tumour of the right atrium. Malignancy of the tumour was strongly suspected on the basis of magnetic resonance findings. At surgery, the tumour could not be removed and multiple biopsies showed that it was an angiosarcoma with metastases in the lymph nodes and the lungs, the latter presenting as carcinomatous miliary. This case is of interest because of the unusual way the tumour was discovered with a possible alternative diagnosis of cardiac tuberculoma, and because of the usefulness of magnetic resonance imaging to diagnose cardiac tumours and evaluate the extension of those which are malignant.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.