A CASE REPORT OF CONSTRICTIVE PERICARDITIS DUE TO TUBERCULOSIS IN ADOLESCENCE
Athiyatul Aufie,Najib Advani
Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo Hospital
Background : Constrictive pericarditis in children/adolescence is a rare condition and has uncharacteristic clinical picture in which the pericardium become inflamed, thickened, fused or fibrotic that may impair diastolic filling.
Case Presentation Summary : A 15-year-old boy was admitted with complaints of abdominal swelling, leg edema, difficulty in breathing and increasing fatigue since 4 months. Physical examination revealed increased jugular venous pressure, massive ascites, and bilateral leg edema. IGRA examination and mantoux test showed positive result for tuberculosis. Cardiomegaly, pericardial calcification and pericardial thickness 4-5 mm were seen in thoracic CT. Echocardiography revealed severe diastolic dysfunction due to constrictive pericarditis or restrictive cardiomyopathy with mild to moderate MR. The final diagnosis was constrictive pericarditis due to tuberculosis. He had pericardiectomy followed by pharmacological treatment involving anti-tuberculosis and anti-failure drugs. Histopathological examination revealed chronic pericarditis with calcification foci and lymphoid hyperplasia. Patient had clinical improvement 2 months following surgery, doing basic activity and started school 3 months after surgery. He could perform vigorous activity 8 months after surgery.
Learning Points/Discussion : Patient presented with constrictive pericarditis due to tuberculosis. He underwent pericardiectomy and have to be followed up routinely to evaluate the clinical function, heart function, and possible side effect of procedure to ensure a good quality of life. So far, there are no clinical side effect post surgery
Keywords: constrictive pericarditis tuberculosis surgery
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