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Case report
Favourable outcome in a child with presumed tubercular pancarditis treated with empirical antitubercular therapy
  1. Sanjeev Khera1,
  2. Vivek Kumar1,
  3. Ravi Ramamurthy1 and
  4. Praveen Ramar2
  1. 1Department of Pediatrics, Army Hospital Research and Referral, New Delhi, India
  2. 2Department of Pediatrics, Command Hospital Chandigarh, Chandigarh, India
  1. Correspondence to Dr Sanjeev Khera; kherakherakhera{at}gmail.com

Abstract

Cardiac tuberculosis (TB) as an extrapulmonary manifestation of TB is rare. Pericarditis is a common manifestation while myocarditis and endocarditis are less common. Tubercular pancarditis is extremely rare. Endomyocardial involvement of TB is generally clinically silent and present as sudden death due to arrhythmias. It is recommended that empirical antitubercular therapy (ATT) on the basis of clinical suspicion should be avoided in countries where TB is highly prevalent. However, delaying ATT in endomyocardial TB and extensive investigations for demonstration or culture of acid-fast bacilli (AFB) may be associated with morbidity and may lead to catastrophic consequences, especially in a sick child. We present a child with TB pancarditis who presented with congestive cardiac failure and empirical ATT was started after extensive efforts to demonstrate AFB failed and the outcome was good.

  • TB and other respiratory infections
  • pericardial disease
  • heart failure
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Footnotes

  • Contributors SK has conceptualised, contributed to diagnosis and management of the case and has written the manuscript. VK, RR and PR have contributed to diagnosis and management of the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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