EJMCR |

Case Report

Volume: 9 | Issue: 6 | Published: Jul 25, 2025 | Pages: 140 - 144 | DOI: 10.24911/ejmcr.9-2047

Tuberculosis as the cause of recurrent pericardial effusion: a case report

Authors: Pim S van Sambeeck , Cynthia van Arkel , Stefan M van der Heide , Leen AFM van Garsse

Authors

Pim S van Sambeeck

Department of Cardio-Thoracic Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, The Netherlands

ORCID

Cynthia van Arkel

Department of Pulmonology, Radboud University Medical Center, Radboud Institute for Health Sciences, The Netherlands

Stefan M van der Heide

Department of Cardio-Thoracic Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences

Leen AFM van Garsse

Department of Cardio-Thoracic Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, The Netherlands

Publication History

Received: May 29, 2025

Accepted: July 09, 2025

Published: July 25, 2025

Abstract

Background: Pericardial effusion (PE), affecting approximately 3% of the Western population, has diverse aetiologies including heart failure, malignancy, autoinflammatory, metabolic, or microbiological diseases, and can be induced by trauma or drugs. Guidelines suggest early tuberculosis (TB) testing in patients with PE. However, clinicians in Western Europe often overlook this diagnosis. Therefore, the aim of this report is to emphasize the importance of considering this diagnosis.

Case Presentation: A 72-year-old woman, with a history of aortic valve replacement, was referred for episodes of PE without diagnosis, severe tricuspid insufficiency, and an atrial flutter. PE resisted high-dose anti-inflammatory treatment for sterile pericarditis after ruling out cardiac, banal bacterial, malignant, and autoimmune causes. She underwent surgical tricuspid valve repair with isthmus ablation, and bilateral pericardiopleural windows were created. TB was confirmed via QuantiFERON test and polymerase chain reaction of the pericardial fluid obtained during surgery. Antibiotic and corticosteroid treatment for TB was started with outpatient monitoring. The symptoms decreased after the final antibiotic and corticosteroid therapy.

Conclusion: This case report emphasizes the importance of considering TB as a potential cause of unexplained, recurrent PE in an immunocompetent patient from a non-endemic area, as stated in the guidelines. Especially in an increasingly intercontinental world. Early testing can expedite the start of treatment, reducing complications, invasive procedures, and improving outcomes.

Keywords: Pericardial effusion, cardiac tamponade, tuberculosis, pericardiopleural window surgery, case report.

Pubmed Style

Pim S van Sambeeck, Cynthia van Arkel, Stefan M van der Heide, Leen AFM van Garsse. Tuberculosis as the cause of recurrent pericardial effusion: a case report. EJMCR. 2025; 25 (July 2025): 140-144. doi:10.24911/ejmcr.9-2047

Web Style

Pim S van Sambeeck, Cynthia van Arkel, Stefan M van der Heide, Leen AFM van Garsse. Tuberculosis as the cause of recurrent pericardial effusion: a case report. https://www.ejmcr.com/articles/2047 [Access: August 14, 2025]. doi:10.24911/ejmcr.9-2047

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Pim S van Sambeeck, Cynthia van Arkel, Stefan M van der Heide, Leen AFM van Garsse. Tuberculosis as the cause of recurrent pericardial effusion: a case report. EJMCR. (2025), [cited August 14, 2025]; 25 (July 2025): 140-144. doi:10.24911/ejmcr.9-2047

Harvard Style

Pim S van Sambeeck, Cynthia van Arkel, Stefan M van der Heide, Leen AFM van Garsse (2025) Tuberculosis as the cause of recurrent pericardial effusion: a case report. EJMCR, 25 (July 2025): 140-144. doi:10.24911/ejmcr.9-2047

Chicago Style

Pim S van Sambeeck, Cynthia van Arkel, Stefan M van der Heide, Leen AFM van Garsse. "Tuberculosis as the cause of recurrent pericardial effusion: a case report." 25 (2025), 140-144. doi:10.24911/ejmcr.9-2047

MLA (The Modern Language Association) Style

Pim S van Sambeeck, Cynthia van Arkel, Stefan M van der Heide, Leen AFM van Garsse. "Tuberculosis as the cause of recurrent pericardial effusion: a case report." 25.July 2025 (2025), 140-144. Print. doi:10.24911/ejmcr.9-2047

APA (American Psychological Association) Style

Pim S van Sambeeck, Cynthia van Arkel, Stefan M van der Heide, Leen AFM van Garsse (2025) Tuberculosis as the cause of recurrent pericardial effusion: a case report. , 25 (July 2025), 140-144. doi:10.24911/ejmcr.9-2047