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PubMed1998

Valvular endocarditis due to Mycobacterium tuberculosis.

Granulomas due to Mycobacterium tuberculosis are rarely observed in valvular structures. When observed, they are associated with disseminated tuberculosis in immunocompromised patients. We report the first case of tuberculous valvular endocarditis isolated in an immunocompetent patient. The patient had severe mitral valve regurgitation due to a perforation of the anterior leaflet of the mitral valve. M. tuberculosis was cultured from the vegetations and no other tuberculous foci were identified. This case exemplifies the protean manifestations of M. tuberculosis infections.

Endocarditis, Bacterial↗
PubMed1976

Total electrical alternans in a patient with tuberculous pericarditis.

Total electrical alternans is an uncommon electrocardiographic abnormality in which alternation in the direction and/or amplitude of all the components (P, QRS and T) of the tracing is present. The phenomenon is seen only in association with occasional cases of pericaditis with large effusion's. Knowledge of this fact may help in the often difficult differentiation between a pericardial effusion and cardiomyopathy. An illustrative case report is presented, with a résumé of the mechanisms postulated to explain total electrical alternans.

Adult↗
PubMed1998

[Tuberculosis in circulation system].

Tuberculous pericarditis develops either via hematogenous or lymphangeal spread, or directly from pulmonary lesions. Tuberculous pericarditis begins with fibrin deposits, granuloma formation, and the presence of live acid-fast bacilli. A pericardial effusion, which is serous but often contains some blood with a high level of protein. Recently, PCR technology has been employed to amplify M. Tuberculosis DNA from pericardial fluid. The elevation of ADA (> 45 U/l) is supportive of the diagnosis. Tuberculous pericarditis is detected clinically either in the effusive stage by nonspecific systemic syndrome or after the development of constrictive pericarditis. The short-course treatment of tuberculous pericarditis should consist of three-drug regimen, such as INH, RFP, PZA, SM, EB. The use of prednisolone is controversial. Tuberculous myocarditis is extremely rare because of low affinity between M. Tuberculosis and myocardium. Most cases of tuberculous pericarditis are clinically silent and diagnosed at autopsy.

Humans↗