The Diagnostic Challenge of Extrapulmonary Tuberculosis: Esophageal Perforation, Mediastinitis, Pneumopericardium, and Pericardial Abscess Formation

Tijs Bringmans; Inne Vanreusel; Adrien Coquilhat; Stef Derwa; Sabrina H van Ierssel; Dina De Bock; Constantijn Franssen

doi:10.1016/j.jaccas.2019.10.036

The Diagnostic Challenge of Extrapulmonary Tuberculosis: Esophageal Perforation, Mediastinitis, Pneumopericardium, and Pericardial Abscess Formation

JACC Case Rep. 2020 Jan 8;2(2):266-270. doi: 10.1016/j.jaccas.2019.10.036. eCollection 2020 Feb.

Authors

Tijs Bringmans¹, Inne Vanreusel², Adrien Coquilhat², Stef Derwa³, Sabrina H van Ierssel⁴, Dina De Bock³, Constantijn Franssen¹

Affiliations

¹ Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium.
² Department of Internal Medicine, University of Antwerp, Antwerp, Belgium.
³ Department of Cardiovascular and Thoracic Surgery, Antwerp University Hospital, Antwerp, Belgium.
⁴ Department of General Internal Medicine, Antwerp University Hospital, Antwerp, Belgium.

Abstract

We describe the case of extrapulmonary tuberculosis complicated by esophageal perforation, pneumopericardium, and pericardial abscess formation. This case illustrates the difficulty in diagnosing extrapulmonary tuberculosis, as the occurrence of tuberculosis is rare in the developed world. The appropriate treatment strategy and 6-month follow-up results are discussed. (Level of Difficulty: Advanced.).

Keywords: CT, computed tomography; EBUS-TBNA, endobronchial ultrasonography-transbronchial needle aspiration; ELISA, enzyme-linked immunosorbent assay; HIV, human immunodeficiency virus; MTB/RIF, Mycobacterium tuberculosis/rifampicin; PCR, polymerase chain reaction; PET, positron emission tomography; extrapulmonary tuberculosis; mediastinal tuberculosis; tuberculosis; tuberculous esophageal perforation; tuberculous pericardial abscess.

Publication types

Case Reports