A case of tuberculous pericarditis successfully treated with anti-tuberculous drugs and pericardiectomy was reported. A61-year-old male was admitted because of cough with bloody sputum and dyspnea on exercise. Chest X-rays and thoracic CT scan revealed pleural effusion, pericardial effusion and thickened pericardium. His clinical symptoms and signs suggested cardiac tamponade. Mycobacterium tuberculosis was detected from pericardial effusion obtained by pericardiocentesis. The diagnosis of tuberculous pericarditis was confirmed. Anti-tuberculous therapy consisting of INH, RFP and EB was started and continuous drainage of pericardial effusion was performed. However, the drainage was not successful because of the high viscosity of the pericardial fluid. Then pericardiectomy was carried out by a median sternotomy method. After the operation his general condition had markedly improved and the pericardial effusion disappeared. In conclusion the pericardiectomy should be tried for tuberculous pericarditis when therapy with anti-tuberculous drugs and pericardial tube drainage are not effective.
