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September 6, 2026CureusOpen Access

Medical therapy improves symptoms in a case of active tuberculous pericarditis with constrictive physiology.

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Population

20-year-old immunocompetent man presenting with a one-month history of weight loss, profuse night sweats…

Design

Case_report

Follow-up

short-term

Key result

In a 20-year-old man with tuberculous pericarditis, multimodality imaging revealed active pericardial inflammation and constrictive physiology, leading to symptomatic improvement after medical therapy.

Authors

NLNadia LoudiyiHEHafsa ErreguiMMMohamed Malki

Discussion

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Overview

May support multimodality imaging to identify reversible constriction in tuberculous pericarditis; hypothesis-generating and requires prospective validation.

Key Points

  • To describe the diagnostic utility of multimodality cardiovascular imaging in identifying active inflammation and constrictive physiology in a young patient with tuberculous pericarditis.
  • Evaluated a 20-year-old immunocompetent male presenting with constitutional symptoms and chest pain using transthoracic echocardiography, contrast-enhanced CT, and cardiac magnetic resonance (CMR).
  • Analyzed pericardial fluid using the Xpert MTB/RIF assay and mycobacterial culture, followed by initiation of a six-month antituberculous and adjunctive corticosteroid regimen.
  • Echocardiography and CT identified marked pericardial thickening, moderate circumferential effusion, septal bounce, and an approximate 25% respiratory variation in transmitral flow.
  • CMR showed intense late gadolinium enhancement of the pericardium signifying active inflammation, and microbiological testing confirmed Mycobacterium tuberculosis.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
A 20-year-old immunocompetent man with tuberculous pericarditis and constrictive physiology.
I
Intervention
Six-month antituberculous regimen (rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months, followed by rifampicin and isoniazid for 4 months) combined with adjunctive oral prednisolone (120 mg/day tapered over 6 weeks).
O
Outcome
Clinical and echocardiographic evolution at short-term follow-up

Multimodality imaging, including echocardiography, CT, and CMR, is crucial for characterizing tuberculous pericarditis with constrictive physiology and identifying active inflammation that may be potentially reversible with medical therapy.

Limitations

  • Longer-term clinical and imaging follow-up was not yet available to confirm reversibility of constrictive physiology.
  • Longer-term clinical and imaging follow-up was not yet available to confirm actual reversibility of constrictive physiology.

Cite This Study

Loudiyi et al. (2026) conducted a case report in Tuberculous pericarditis (n=1). Antituberculous therapy and corticosteroids was evaluated on Clinical and echocardiographic response. In a 20-year-old man with tuberculous pericarditis, multimodality imaging revealed active pericardial inflammation and constrictive physiology, leading to symptomatic improvement after medical therapy.

synapsesocial.com/papers/6a9d1df228139818eab20af3https://doi.org/10.7759/cureus.115722
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A case of acute tuberculous pericarditis evolving into pericardial constriction after 32 years: A case report2025
  2. 2Tuberculous constrictive pericarditis: challenges and surgical management2025
  3. 3ECMO-Supported Pericardiectomy in Constrictive Tuberculous Pericarditis With Severe Ventricular Dysfunction2026
  4. 4Unmasking Tuberculosis: A Case of Pericardial Effusion in a Young Adult With Recurrent Pneumonia2025
  5. 5A Case Series of Tuberculous Pericarditis: Clinical Profiles and Diagnostic Challenges2026