A case report of a 24-year-old male with a large hemorrhagic pericardial effusion.pdfVIP

． 236． 微生物与感染 JournalofMicrobesandInfections，December25，2011，6(4)：236—237 http：∥jmi．fudan．edu．cn 病 例 分 析 A case report of a 24—-year。。old male with a large h一em orrh’agi·cperl●CarC1Il●aI1etntnuSl●on JIN Jia—Lin，YANGFei—Fei，ZHANGWan—Qin，ZHANGWen—Hong DepartmentofInfectiousDiseases，HuashanHospita，，FudanUniversity，Shanghai200040，China Abstract：Although bloody pericardialeffusion often suggests neoplasia， such an event is not rare in tuberculosis(TB)，especiallyinthosecountrieswithahighTB diseaseburden．Meanwhile，TB accountsfor 50％ andgreaterthan90％ oflargepericardialeffusionsinhuman immunodeficiencyvirus(HIV)一negative andHIV-positivepatients。respectively．Herewereportacaseofa24一year-oldHIV—negativemalewho presentedwith fever and hemorrhagic pericardialeffusion．The patientwasgiven presumptive anti—TB treatmentbeforediagnosiswasestablished．Eventuallythepatientrespondedwellto theanti—TB treatment atthelastfollow-·upandthediagnosiswasconfirmedbyaspiratedpericardialfluidcultureonLowenstein·· Jensen (LJ)medium ． Keywords：Adult；Hemorrhagictuberculouspericarditis；Tuberculosis A 24．year—oldhuman immunodeficiencyvirus icterusorhepatosplenomegalywerefound． (|nV)一negativemalepatientwasadmittedon 26th Laboratoryinvestigationsrevealedawhiteblood M arch 2007，suffering from fever(temperature cell(WBC)countof6．2×10。／L．withpolymorphs rangedbetween38—39℃ )，paroxysmalchestpain， 67．1％ ，lymphocytes 19．1％ ；hemoglobin (Hb) dry nonproductiVe cough，anorexia，and fatigue of132g／L；plateletcountof235×10／L；andan for9d．Beforeadmission，thepatientwastreated erythrocytesedimentationrate(ESR)of49mm／ withantibiotics，includingcefuroxime，levofloxacin， h．Hewasseronegative forHIV and thehepatic andribavirin，forinjectionforoneweekinthe and renal function tests were within normal outpatientclinic．Howe