Use of the rapid molecular test in the diagnosis of pericardial tuberculosis: a case report

Authors

  • Andréia Moreira dos Santos Carmo
  • Maria Cecilia Cergole Novella
  • Paolo Jose Cesare Biselli
  • Wagner Issao Hoshino
  • Akemi Oshiro Guirelli
  • Valéria dos Santos Candido

DOI:

https://doi.org/10.18554/refacs.v5i2.2067

Keywords:

tuberculous pericarditis, real-time polymerase chain reaction, Mycobacterium tuberculosis

Abstract

This study aims at reporting the case of a patience who presented with drowsiness and mental confusion, received in the emergency room of a university hospital in São Paulo. Symptoms included fever, weight-loss and pneumonia. Computerized tomography and ecocardiography found: attenuation of the mediastinum, pleural effusions, discrete centrilobular opaqueness in both lung lobes and mediastinum lymph nodes, left ventricle diffuse hypokinesia with a discrete systolic dysfunction, left atrium dilation and moderate pericardial effusion. The patient presented positive serology for the human immunodeficiency virus (HIV). Baciloscopies of pleural liquid, pericardial liquid and catarrh were negative; the rapid molecular test (RMT-TB) of the pericardial liquid, however, was positive for Mycobacterium tuberculosis, with no rifampicin resistance. The culture evidenced the growth of M. tuberculosis. An anti-retroviral treatment for TB was started. The access to the RMT-TB in cases of extrapulmonary tuberculosis is paramount for an early diagnosis, with direct impact in the prognosis of serious cases of patients who are co-infected by HIV/TB.

References

Echeverri D, Matta L. Tuberculous pericarditis. Biomedica 2014; 34, (4): 528-34. Accedido en: 09/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/25504241>.

Rieder HL. Challenges in the diagnosis of extrapulmonary tuberculosis. Indian J Tuberc. 2016; 63(2):67-8. Accedido en: 09/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/27451811>.

Imazio M. Pericarditis: pathophysiology, diagnosis, and management. Curr Infect Dis Rep. 2011; 13(4):308-16. Accedido en: 09/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/21534015>.

Boerrigter BG, Van Sandwijk MS, Van Den Berk GE. A breathtaking response to tuberculosis therapy. Neth J Med. 2013; 71(5):258-62. Accedido en: 14/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/23799314>.

Ministério da Saúde (Br). Boletim Epidemiológico. Brasilia: Ministério da Saúde - Secretaria de Vigilância em Saúde. 46: 19p. 2015.

Tortoli E, Russo C, Piersimoni C, Mazzola E, Dal Monte P, Pascarella M, et al. Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. Eur Respir J. 2012; 40(2):442-7. Accedido en: 14/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/22241741>.

Rufai SB, Singh A, Kumar P, Sing J, Sing S. Performance of Xpert MTB/RIF assay in diagnosis of pleural tuberculosis by use of pleural fluid samples. J Clin Microbiol. 2015; 53(11):3636-8. Accedido en: 14/08/2016. Disponible en: <http://www.ncbi.nlm.nih.gov/pubmed/26311855>.

Hillemann D, Ruch-Gerdes S, Boehme S, Richter E. Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. J Clin Microbiol. 2011; 49(4):1202-5. Accedido en: 09/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/21270230>.

Khandaker MH, Espinosa RE, Nishimura RA, Sinak LJ, Hayes SN, Melduni RM et al. Pericardial disease: diagnosis and management. Mayo Clin Proc. 2010; 85(6):572-93. Accedido en: 10/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/20511488>.

Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician. 2005; 72(9):1761-8. Accedido en: 14/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/16300038>.

Dhana AV, Pauline Howell, Ian Sanne, David Spencer. Identification of Mycobacterium tuberculosis from pericardial fluid using the new Xpert MTB/RIF assay. BMJ Case Rep. 2013; 2013. Accedido en: 15/08/2016. Disponible en: <https://www.ncbi.nlm.nih.gov/pubmed/23986128>

Published

2017-04-11

How to Cite

Carmo, A. M. dos S., Novella, M. C. C., Biselli, P. J. C., Hoshino, W. I., Guirelli, A. O., & Candido, V. dos S. (2017). Use of the rapid molecular test in the diagnosis of pericardial tuberculosis: a case report. JOURNAL FAMILY, CYCLES OF LIFE AND HEALTH IN SOCIAL CONTEXT, 5(2), 263–268. https://doi.org/10.18554/refacs.v5i2.2067

Issue

Section

Case Study