Paradoxical pericarditis in an immunocompetent patient with mediastinal tuberculous lymphadenitis and endobronchial TB: A case report.

Tomohiro Oba, Hidekazu Matsushima, Masako Amano, Keiichi Akasaka, Tomotaka Nishizawa

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In one paragraph

Article in IDCases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed

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5 · Who and what money

Authors and funding

5 authors.

Tomohiro ObaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.

Hidekazu MatsushimaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.

Masako AmanoDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.

Keiichi AkasakaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.

Tomotaka NishizawaDepartment of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Paradoxical reaction (PR) refers to a worsening of existing or new TB-related lesions after initiating effective anti-tuberculosis therapy. While commonly observed in lymph node or CNS TB, PR involving the pericardium is exceedingly rare in immunocompetent patients. Case presentation: A 22-year-old Vietnamese man with mediastinal tuberculous lymphadenitis and endobronchial TB was started on standard anti-TB therapy. After initial improvement, he developed pericardial effusion three months into treatment. Cultures and PCR were negative, but elevated ADA levels were detected. Based on clinical course and exclusion of treatment failure or coinfection, paradoxical pericarditis was diagnosed. Corticosteroids and levofloxacin were added empirically, with resolution of symptoms. Conclusion: This case highlights a rare extrapulmonary manifestation of PR, reinforcing the need to distinguish it from treatment failure or TB progression in immunocompetent hosts.

Indexed as

Endobronchial tuberculosisLymphadenitisParadoxical reactionPericarditisTuberculosis

Identifiers

PMID41473475

DOI10.1016/j.idcr.2025.e02363

PMCPMC12747237

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