An unusual cause of a large fibrinous pericardial effusion
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Abstract
The majority of fibrinous pericardial effusions in sub-Saharan Africa are caused by tuberculosis (TB), which accounts for such effusions in more than 80% of HIV-positive patients, and 50 to 70% of HIV-negative patients in the region.1-4 Consequently, it is a common clinical practice to commence patients on TB treatment on the basis of a fibrinous pericardial effusion seen on echocardiogram.

While this strategy may have merit, there is the risk that patients with less-common causes of a fibrinous effusion may have their diagnosis and treatment unduly delayed. We present a patient who had a large fibrinous pericardial effusion, which was managed as tuberculosis, but this turned out not to be the case.

Case report
A 24-year-old male was referred from a peripheral hospital complaining of two months’ history of shortness of breath on exertion, left-sided pleuritic chest pain, a non-productive cough and significant weight loss. He had lost 17 kg over two months and had drenching night sweats.

He had drunk at least 40 units of alcohol per week and smoked two packs of cigarettes per week for a year. He had no significant medical history and had tested HIV negative a month prior to presentation.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763481/
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