BMJ Case Reports 2011; doi:10.1136/bcr.06.2011.4409
  • Unusual association of diseases/symptoms

Tuberculous pericarditis associated with hoarseness of voice due to left recurrent laryngeal nerve paralysis

  1. Iman M Fouda5
  1. 1Department of Internal Medicine, Kasr Elaini Hosp-Cairo University, Cairo, Egypt
  2. 2Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, United States
  3. 3Department of Radiology, Kasr Elaini Hosp-Cairo university, Cairo, Egypt
  4. 4Department of Internal Medicine, Beny Suef University, Beny Suef, Egypt
  5. 5Department of Internal Medicine, National research centre, Cairo, Egypt
  1. Correspondence to Dr Hussam Ammar, h_ammar70{at}


A 16-years-old Egyptian girl presented with massive pericardial effusion, fever, weight loss and hoarseness of voice. Laryngoscopy showed left vocal cord paralysis. Chest CT revealed pericardial effusion, amalgamated mediastinal lymph nodes and clear lung fields. Pericardial fluid analysis revealed a lymphocytic exudate with high adenosine deaminase enzyme level, negative stains and cultures for bacteria and fungi. Despite a negative nucleic acid test for tuberculosis; antituberculous and corticosteroids therapies resulted in resolution of pericardial effusion after 3 weeks but hoarseness of voice persisted. Few cases of vocal cord paralysis with tuberculous mediastinal lymphadenopathy were reported in English literature.


  • Competing interests None.

  • Patient consent Obtained.

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