تقرير
أعرض في EDS

Partial pericardiectomy for refractory acute tuberculous pericarditis: A case report.

التفاصيل البيبلوغرافية
العنوان: Partial pericardiectomy for refractory acute tuberculous pericarditis: A case report.
المؤلفون: Fernandes AL; Division of Cardiovascular Surgery, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Dinato FJ; Division of Cardiovascular Surgery, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: fabricio.dinato@incor.usp.br., Veronese ET; Division of Cardiovascular Surgery, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., de Almeida Brandão CM; Division of Cardiovascular Surgery, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Aiello VD; Department of Pathology, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Jatene FB; Division of Cardiovascular Surgery, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil.
المصدر: International journal of surgery case reports [Int J Surg Case Rep] 2023 May; Vol. 106, pp. 108239. Date of Electronic Publication: 2023 Apr 19.
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 101529872 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2210-2612 (Print) Linking ISSN: 22102612 NLM ISO Abbreviation: Int J Surg Case Rep Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Amsterdam] : Elsevier B.V.
مستخلص: Introduction: Tuberculosis is an infectious disease that usually manifests in the lungs but can also affect other organs, including the cardiovascular system. In this article, we present a rare case of purulent pericarditis caused by Mycobacterium tuberculosis.
Presentation of Case: A 67-year-old man was admitted to the emergency department with a large pericardial effusion with evidence of cardiac tamponade caused by acute pericarditis. The patient underwent surgical pericardial drainage, and a total volume of 500 mL of purulent fluid was collected with a positive culture for Mycobacterium tuberculosis. Despite antituberculous drugs, the patient presented with clinical worsening and recurrence of large pericardial effusion. Therefore, he was submitted to a second intervention by full median sternotomy to drain the pericardial effusion and perform a surgical pericardial debridement associated with a partial pericardiectomy. After the procedure, he improved clinically and was discharged after 24 days of hospitalization.
Discussion: Pericardiectomy is recommended for patients with refractory tuberculous pericarditis after four to eight weeks of antituberculous treatment. We decided not to wait that long to perform an open surgical partial pericardiectomy and debridement with a median sternotomy approach. We believe that this more aggressive surgical approach would be more efficient to combat the infection, which was causing progressive deterioration of patient's clinical condition and early recurrence of significant pericardial effusion.
Conclusion: Open partial pericardiectomy with surgical debridement could be an efficient approach for treatment of a refractory acute tuberculous pericarditis.
Competing Interests: Conflict of interest statement No conflicts of interest.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
فهرسة مساهمة: Keywords: Mycobacterium tuberculosis; Pericardiectomy; Pericarditis; Tuberculous pericarditis
تواريخ الأحداث: Date Created: 20230423 Latest Revision: 20230516
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10149216
DOI: 10.1016/j.ijscr.2023.108239
PMID: 37087940
قاعدة البيانات: MEDLINE
الوصف
تدمد:2210-2612
DOI:10.1016/j.ijscr.2023.108239