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What is A 23-year old female pateint presents with 2 months history of low grade fever and moderate right-sided pleural effusion. Pleural fluid shows lymphocyte predominance with ADA levels of 120IU/L. The patient is staed on anti-tubercular therapy (WHO catergory 1). Two months later the patient presents with progressive breathlessness, generalized body swelling and raised JVP. Pleural fluid is now predominantyl transudate. This patient is liekly to have developed- and explain in detail?
Here in this case,the patient has initially developed pleural TB and eventually developed tuberculous pericarditis due to either direct extension from adjacent mediastinal hilar lymph nodes or due to hematogenous spread.The onset may be subacute,with dyspnea,fever,dull retrosternal pain,and pericardial friction rub.An effusion(transudative) eventually develops with symptoms and signs of cardiac tamponade like generalised body swelling. Ref:Harrison's medicine-18th edition,page no:1348,1349.