Pneumopericardium in a young patient with tuberculous pericarditis

Abstract

A 19-year old male presented in the Emergency Room complaining of dyspnea that progressively worsened in the previous week. He also reported asthenia and dry cough in the last month. Clinical exam showed altered general status, pale skin, polypnea, tachycardia at 124 heart beats/min, deafened heart sounds, blood pressure of 100/60 mmHg and jugular vein turgescence. Auscultation of the lungs revealed no abnormal findings. The chest X-ray showed the presence of air surrounding the heart with a sharply outlined pericardium (Panel A, arrows). The CT scan showed minimal pericardial fluid effusion and a remarkable pneumopericardium (Panel B). The patient was sent to the Thoracic Surgery Department where pericardial drainage was done. The biological exam of the pericardial liquid confirmed the suspicion of tuberculous pericarditis. He was discharged with standard antituberculous treatment