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Tuberculous pericardial effusion after coronary artery bypass graft. 2006

Sampurna M Tuladhar, and Mahdad Noursadeghi, and Joseph J Boyle, and Jon S Friedland, and Philip Hornick
Department of Cardiac Surgery, Hammersmith Hospital, London, United Kingdom.

We describe a case of a recurrent pericardial effusion after coronary artery bypass grafting. This was initially considered to be due to post-pericardiotomy syndrome, but was later treated empirically as tuberculosis. After definitive surgery for this condition, pericardial histology and immunohistochemistry confirmed the diagnosis of tubercular pericarditis. At 4-months follow-up, while continuing anti-tuberculous therapy and corticosteroids, the patient showed consistent improvement without further recurrence of his pericardial effusion. Local reactivation of tuberculosis after pericardiotomy has not been previously reported and merits careful consideration in population groups in which tuberculosis is highly endemic.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010490 Pericardial Effusion Fluid accumulation within the PERICARDIUM. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of THORACIC DUCT. Severe cases can lead to CARDIAC TAMPONADE. Chylopericardium,Hemopericardium,Chylopericardiums,Effusion, Pericardial,Effusions, Pericardial,Pericardial Effusions
D010491 Pericardial Window Techniques Surgical construction of an opening or window in the pericardium. It is often called subxiphoid pericardial window technique. Pericardiostomy,Pericardial Window Technics,Pericardial Window Technic,Pericardial Window Technique,Pericardiostomies,Technic, Pericardial Window,Technics, Pericardial Window,Technique, Pericardial Window,Techniques, Pericardial Window,Window Technic, Pericardial,Window Technics, Pericardial,Window Technique, Pericardial,Window Techniques, Pericardial
D010496 Pericardium A conical fibro-serous sac surrounding the HEART and the roots of the great vessels (AORTA; VENAE CAVAE; PULMONARY ARTERY). Pericardium consists of two sacs: the outer fibrous pericardium and the inner serous pericardium. The latter consists of an outer parietal layer facing the fibrous pericardium, and an inner visceral layer (epicardium) resting next to the heart, and a pericardial cavity between these two layers. Epicardium,Fibrous Pericardium,Parietal Pericardium,Pericardial Cavity,Pericardial Space,Serous Pericardium,Visceral Pericardium,Cavities, Pericardial,Cavity, Pericardial,Pericardial Cavities,Pericardial Spaces,Pericardium, Fibrous,Pericardium, Parietal,Pericardium, Serous,Pericardium, Visceral,Pericardiums, Fibrous,Pericardiums, Serous,Serous Pericardiums,Space, Pericardial,Spaces, Pericardial
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D004322 Drainage The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D005938 Glucocorticoids A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. Glucocorticoid,Glucocorticoid Effect,Glucorticoid Effects,Effect, Glucocorticoid,Effects, Glucorticoid
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000995 Antitubercular Agents Drugs used in the treatment of tuberculosis. They are divided into two main classes: "first-line" agents, those with the greatest efficacy and acceptable degrees of toxicity used successfully in the great majority of cases; and "second-line" drugs used in drug-resistant cases or those in which some other patient-related condition has compromised the effectiveness of primary therapy. Anti-Tuberculosis Agent,Anti-Tuberculosis Agents,Anti-Tuberculosis Drug,Anti-Tuberculosis Drugs,Antitubercular Agent,Antitubercular Drug,Tuberculostatic Agent,Tuberculostatic Agents,Antitubercular Drugs,Agent, Anti-Tuberculosis,Agent, Antitubercular,Agent, Tuberculostatic,Anti Tuberculosis Agent,Anti Tuberculosis Agents,Anti Tuberculosis Drug,Anti Tuberculosis Drugs,Drug, Anti-Tuberculosis,Drug, Antitubercular

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