Cardiac tamponade associated with meningoencephalitis, atypical tuberculosis

Abstract

Tuberculosis remains a disease with a high incidence worldwide even today. Albeit progress has been made in new methods to diagnose it, on many occasions disease identification keeps being a challenge, especially in extrapulmonary cases given the non-specific nature of its symptoms. A high clinical suspicion of disease with a multidisciplinary and systematic approach, become essential tools for early recognition and timely treatment. Despite advances in immunopathogenesis knowledge, unclear areas continue to exist, such as the individual response to bacillus infection and particular susceptibility to serious forms.  Treatment paradoxical reactions are an example of these uncertainties. The combination of steroids and antibiotic treatment has been shown to reduce mortality and sequelae, particularly in extrapulmonary forms. Despite appropriate diagnosis and treatment, sometimes the disease advances to an ineluctable death because of the advanced presentation at first approach. The case of a patient with a clinic of pericardial effusion and cardiac tamponade is presented. He subsequently presents data of tuberculosis meningoencephalitis and despite an early diagnosis and appropriate treatment after his hospitalization, evolves to hydrocephalus by requiring surgical shunt and subsequently dies from related complications.