RESUMO
Extrapulmonary tuberculosis (TB) contributes to 15% of total cases, representing a great diagnostic and therapeutic challenge. Pericardial involvement is present in 1 to 2% of TB patients and is considered an unusual presentation form of TB. We report a 67-year-old male presenting with fever and progressive dyspnea. A chest CAT scan showed a bilateral pleural effusion and an extensive pericardial effusion. An echocardiogram showed signs of tamponade. Therefore, an emergency pericardiectomy was performed. The pathological report of pericardial tissue showed caseating necrosis and its Koch culture was positive. The patient was treated with anti-tuberculous drugs with a favorable evolution.
Assuntos
Humanos , Masculino , Derrame Pericárdico/etiologia , Derrame Pericárdico/diagnóstico por imagem , Pericardite Tuberculosa/diagnóstico , Pericardite Tuberculosa/diagnóstico por imagem , Tuberculose , Pericardiectomia , EcocardiografiaAssuntos
Humanos , Feminino , Adolescente , Pericardite Tuberculosa/diagnóstico , Pericardite Tuberculosa/tratamento farmacológico , Pericardite Tuberculosa/diagnóstico por imagem , Tuberculose/complicações , Ecocardiografia Doppler , Corticosteroides/uso terapêutico , Antibióticos Antituberculose/uso terapêuticoRESUMO
To know the findings of MDCT in cases of Abdominal Tuberculosis. Fifty eight patients with suspicion of abdominal tuberculosis were scanned and the findings were evaluated. All the patients received IV and oral contrast. The patients were referred from the medical and surgical departments of Shalamar Hospital, Lahore. Toshiba 4 Slice Aquilion was used for scanning. The exclusion criterion was patients on Anti tuberculous drugs and urogenital tuberculosis. Following 6 findings were observed in 47 abnormal scans, Out of other 11 scans 9 had other diseases like diverticulitis, Appendicitis and Bowel Lymphoma. 2 were normal. Close medical and Surgical follow up was obtained in all cases. Ascites = 35, Omental / Mesenteric Thickening / Involving = 27, Small Bowel wall thickening = 07, Large bowel wall thickening including Caecal wall thickening = 06, Abdominal Lymphadenopathy= 26, Solid Organ Involvement, Liver=01, Spleen=02. Ascites was the most common finding in Patients with Abdominal Tuberculosis and Involvement of liver being the least common finding amongst the group
Assuntos
Humanos , Pericardite Tuberculosa/diagnóstico por imagem , Ascite , Tomografia Computadorizada por Raios X , Tuberculose Gastrointestinal/diagnósticoRESUMO
Tuberculous pericariditis is the most common cause of chronic pericarditis, especially in developing countries. Cystic tuberculous pericarditis is an exceedingly rare type of tuberculosis. Authors discuss clinical manifestations and radiological findings in a patient with cystic tuberculous pericarditis in whom diagnosis was confirmed by pericardial biopsy
Assuntos
Humanos , Feminino , Pericardite Tuberculosa/diagnóstico por imagem , AntituberculososRESUMO
A retrospective analysis of clinical data of 71 patients with constrictive pericarditis (CP) diagnosed by echo-Doppler technique (mean age, 49 +/- 17) was done. In 27 patients (38%), the etiology was unknown, and the three most frequent identifiable causes were tuberculosis (23/71, 32%), cardiac surgery (8/71, 11%), and mediastinal irradiation (6/71, 9%). Pericardiectomy was performed in 35 patients (49%) with a surgical mortality of 6% (2/35), and 11 patients (15%, 11/ 71) showed complete resolution of constrictive physiology with medical treatment. Patients with transient CP were characterized by absence of pericardial calcification, shorter symptom duration, and higher incidence of fever, weight loss, and tuberculosis. The 5-yr survival rates of patients with transient CP and those undergoing pericardiectomy were 100% and 85 +/- 6%, respectively, which were significantly higher than that of patients without undergoing pericardiectomy (33 +/- 17%, p=0.0083). Mediastinal irradiation, higher functional class, low voltage in ECG, low serum albumin, and old age were the independent variables associated with a higher mortality. Tuberculosis is still the most important etio-logy of CP in Korea, and not infrequently, it may cause transient CP. Early diagnosis and decision-making using follow-up echocardiography are crucial to improve the prognosis of patients with CP.