Concurrent tuberculous pericarditis and lung adenocarcinoma presenting with cardiac tamponade

Abstract

Mycobacterium tuberculosis (MTB) infection and lung malignancies are both important causes of pericardial effusion (PE), particularly in developing nations such as South Africa. They are each associated with significant morbidity and mortality and pose several public health challenges for the region. This case study discussed a 58-year-old man who presented acutely with a large PE complicated by cardiac tamponade. Pericardial fluid analysis was positive for TB and further cytopathological evaluation revealed metastatic lung adenocarcinoma. Dual diagnoses are rare; however, considering the rising incidences of lung cancer and its predisposition for infectious diseases, this may be under-reported in TB endemic regions. This case highlighted the importance of considering other causes of PE that may aggravate presentation, leading to life-threatening cardiac tamponade. Further research is needed to understand the impact of rising cancer incidences and ongoing burden of infectious diseases in sub-Saharan Africa.

Contribution: The insights of this case study include the paucity of data surrounding diagnosis and treatment of lung cancer in non-smokers available for South Africa. The current data that are available is for the developed world only. Some evidence incidence might be related to exposure of biofuels, which has significance for our local population and requires more exact research.