Abstract:

This paper reported a case of tuberculous pericardial effusion which was confirmed by GeneXpert MTB/RIF (Mycobacterium tuberculosis rpoB gene and mutation detection). During the early stage of the diagnosis, the routine anti-infection was ineffective, the pathogenic bacteria was not founded in the case, and tumor or other causes were excluded. The clinical diagnosis was considered as tuberculous pericardial effusion, while multiple tests for acid-fast bacilli was negative. The patient’s pericardial effusion was used to perform GeneXpert MTB/RIF test, and positive (very low dose) result was obtained. Through anti-tuberculous treatment, the pericardial effusion of the patient decreased to a small amount and the symptoms improved significantly after 2 weeks. And 3 months later, the symptoms disappeared. The diagnosis and treatment of the patient suggested that multiple methods should be actively applied during the early stage of clinical diagnosing tuberculous pericardial effusion. Beside traditional acid-fast bacillus smear and mycobacterium culture, the adenosine deaminase (ADA) and GeneXpert MTB/RIFF tests for pericardial effusion and interferon-gamma release assay (IGRA) for blood should be considered.

Key words: Tuberculous, Pericardial effusion, GeneXpert MTB/RIF