Pericardial effusion as the first manifestation of occupational tuberculosis in a health care worker

  • Veljko Flego Department of Pulmonology, Clinical Hospital Centre Rijeka, Rijeka
  • Dubravka Matanić Lender Department of Pulmonology, Clinical Hospital Centre Rijeka, Rijeka
  • Ljiljana Bulat-Kardum Department of Pulmonology, Clinical Hospital Centre Rijeka, Rijeka
Keywords: antituberculotics, disseminated tuberculosis, extrapulmonary tuberculosis, nosocomial disease, occupational disease, tuberculous pericarditis

Abstract

Tuberculosis (TB) is an infectious disease and, apart from protecting patients, attention must be given to protecting the persons who come in contact with them, especially nurses and medical practitioners. A 43-year-old immunocompetent male nurse developed occupationally disseminated TB after contact with patients affected by active TB (culture positive) while working in a psychiatric hospital. The first manifestation of the disease was exudative pericarditis with Mycobacterium tuberculosis (MT) confirmed two months after pericardiocentesis and evacuation of 1200 mL of pericardial effusion. Many lymph nodes showed histologic findings of granulomatous inflammation with necrosis. Treatment with antituberculosis drugs caused complications, including transient short-term medication-induced toxic hepatitis, prolonged fever, left pleural nonspecific effusion, and mononeuritis of the right peroneus nerve. The treatment lasted 14 months and led to permanent consequences, including fibrothorax with restrictive ventilation disorders and reduced diffusion of the alveolar-capillary membrane. This case highlights the need to improve the protection of health care workers who are in contact with TB patients, as well as the usefulness of the tuberculin skin test and QuantiFERON-TB test, which can be used to identify early latent TB.
Published
2014-11-27
How to Cite
1.
Flego V, Matanić Lender D, Bulat-Kardum L. Pericardial effusion as the first manifestation of occupational tuberculosis in a health care worker. Arh Hig Rada Toksikol [Internet]. 2014Nov.27 [cited 2022Oct.1];65(4). Available from: https://arhiv.imi.hr/index.php/arhiv/article/view/229
Section
Case report