Atypical presentation of tuberculous constrictive pericarditis: case report and review of the literature.

An 18-year-old Romanian man with no known history of cardiac disease was admitted to the hospital for the management of right heart failure and bilateral pleural effusions. Further investigations revealed mediastinal lymph nodes and a constrictive cardiac haemodynamic pattern. Lymph node biopsy demonstrated a purulent liquid from which cultures were positive for Mycobacterium tuberculosis. The patient improved rapidly with conservative medical management involving antituberculous therapy and diuretics. Tuberculous constrictive pericarditis is rare in Western countries but may still present in migrant populations. As shown in this case, the possibility of atypical and reversible presentations with neither calcifications nor thickening of the pericardium must not be forgotten.