Subacute Cardiac Tamponade Due to Tuberculous Pericarditis Diagnosed by Urine Lipoarabinomannan Assay in a Immunocompetent Patient in Oyam District, Uganda: A Case Report

Elda De Vita, Francesco Vladimiro Segala, James Amone, Kabuga Samuel, Claudia Marotta, Giovanni Putoto, Ritah Nassali, Peter Lochoro, Davide Fiore Bavaro, Jerry Ictho, Samuel Okori, Francesco Di Gennaro () and Annalisa Saracino
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Elda De Vita: Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
Francesco Vladimiro Segala: Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
James Amone: St. John’s XXIII Hospital Aber, Jaber 21310, Uganda
Kabuga Samuel: St. John’s XXIII Hospital Aber, Jaber 21310, Uganda
Claudia Marotta: Doctors with Africa CUAMM, 35100 Padua, Italy
Giovanni Putoto: Doctors with Africa CUAMM, 35100 Padua, Italy
Ritah Nassali: St. John’s XXIII Hospital Aber, Jaber 21310, Uganda
Peter Lochoro: Doctors with Africa CUAMM, Kampala 21310, Uganda
Davide Fiore Bavaro: Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
Jerry Ictho: Doctors with Africa CUAMM, Kampala 21310, Uganda
Samuel Okori: St. John’s XXIII Hospital Aber, Jaber 21310, Uganda
Francesco Di Gennaro: Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy
Annalisa Saracino: Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, 70121 Bari, Italy

IJERPH, 2022, vol. 19, issue 22, 1-6

Abstract: Background: Uganda ranks among the countries with the highest burden of TB the world and tuberculous pericarditis (TBP) affects up to 2% of people diagnosed with pulmonary tuberculosis worldwide. In Africa, it represents the most common cause of pericardial disease. Here, we present the case of a 21-year-old male patient who was diagnosed of cardiac tamponade due to tuberculous pericarditis with a positive urine LF-LAM. Case report: We report a case of a 21-year-old male living in Oyam district, Uganda, who presented to the emergency department with difficulty in breathing, easy fatigability, general body weakness, and abdominal pain. A chest X-ray showed the presence of right pleural effusion and massive cardiomegaly. Thus, percutaneous pericardiocentesis was performed immediately and pericardial fluid resulted negative both for gram staining and real-time PCR test Xpert MTB/RIF. The following day’s urine LF-LAM test resulted positive, and antitubercular therapy started with gradual improvement. During the follow-up visits, the patient remained asymptomatic, reporting good compliance to the antitubercular therapy. Conclusion: Our case highlights the potential usefulness of a LF-LAM-based diagnostic approach, suggesting that, in low-resource settings, this test might be used as part of routine diagnostic workup in patients with pericardial disease or suspected extra-pulmonary tuberculosis.

Keywords: tuberculosis; LF-LAM; Uganda; cardiac tamponade; tuberculous pericarditis (TBP) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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