Tuberculous Pericardial Abscess: A Case Report

結核性心包膜膿瘍

林宗憲(Tsung-Hsien Lin) ； 邱肇基(Chaw-Chi Chiu) ； 黃智興(Chih-Hsin Huang) ； 蔡坤寶(Kun-Bow Tsai) ； 許勝雄(Sheng-Hsiung Sheu)

《The Kaohsiung Journal of Medical Sciences》 21卷7期 (2005/07) Pp. 322-325

摘要

我們報告一位71歲罹患糖尿病男性，其主訴一個月來有氣促現象。胸部X光顯示心臟擴大及兩側肋膜積水。心臟超音波顯示心臟旁有一水泡狀囊腫且壓迫右心室。因為臨床上顯現瀕臨心包膜填塞的症狀，因此我們施行手術並成功移除囊腫。病理檢查顯示如同肺結核感染後所呈現的乳酪狀壞死。病人之後接受一年的抗結核藥治療。這個病歷提醒我們結核感染可以以心包膜膿瘍表現。

關鍵字

心包膜膿瘍 ； 肺結核 ； 縱膈腔腫 ； 乳酪狀壞死 ； 心包膜

並列摘要

We present the case of a 71-year-old diabetic man who came to us complaining of dyspnea for 1 month. Chest X-ray showed cardiomegaly and bilateral pleural effusion. Echocardiography showed a pericardial cystic mass with external compression of the right ventricle. Because of clinically impending cardiac tamponade, we performed urgent sternotomy and removed the pericardial mass without event. Pathologic examination of the excised pericardial specimen showed caseous necrosis compatible with tuberculosis infection. The patient was put on a 1-year treatment regimen of anti-tuberculosis medication. This case is an important reminder that tuberculosis can occur as a pericardial abscess.

並列關鍵字

pericardial abscess ； tuberculosis ； mediastinum mass ； caseous necrosis ； pericardium