A case of loculated pericardial abscess due to tuberculosis in an immunocompetent host

Tuberculosis involving the heart is rare,accounting for only 0.5% of cases of extrapulmonary tuberculosis.Here we are presenting a case of an immunocompetent host who took one-year empirical antitubercular treatment for probable loculated tubercular pericardial abscess.On investigations,loculated pericardial abscess due to Mycobacterium Tuberculosis was confirmed.As patient did not respond to one-year antitubercular treatment and abscess was enlarging on serial computed tomography thorax and could not be aspirated completely due to presence of loculations,pericardiectomy with drainage of pyopericardium was done.This case is an important reminder that TB can manifest as pericardial abscess without significant lung involvement and an early diagnosis and aspiration in above case could have prevented surgical intervention.

Tuberculosis involving the heart is rare, accounting for only 0.5% of cases of extrapulmonary tuberculosis. Here we are presenting a case of an immunocompetent host who took one-year empirical antitubercular treatment for probable loculated tubercular pericardial abscess. On investigations, loculated pericardial abscess due to Mycobacterium Tuberculosis was confirmed. As patient did not respond to one-year antitubercular treatment and abscess was enlargirlg on serial computed tomography thorax and could not be aspirated completely due to presence of loculations, pericardiecto- my with drainage of pyopericardium was done. This case is an important reminder that TB can manifest as pericardial ab- scess without significant lung involvement and an early diagnosis and aspiration in above case could have prevented surgical intervention.