PMC9463754_01
PMC9463754_02
timeline of the patient's illness
PAMJ-42-145-g001.jpg
PMC9463754_02_PAMJ-42-145-g001.jpg
F1
chest X-ray on admission showing massive bilateral pleural effusion
PAMJ-42-145-g002.jpg
PMC9463754_02_PAMJ-42-145-g002.jpg
F2
Electrocardiogram (ECG) showed: sinus tachycardia with right axis deviation, chest X-ray (CXR) showed massive bilateral pleural effusion (Figure 2).
a bottle filled with pus collected after pericardiocentesis
PAMJ-42-145-g003.jpg
PMC9463754_02_PAMJ-42-145-g003.jpg
F3
Pericardiocentesis was done, 950 mls pus drained (Figure 3), drainage was left in situ with improvement.
(A, B) CT scan of the chest showing bilateral partial atelectasis, more on the right lung and pericardial thickening of about 6.9 mm
PAMJ-42-145-g004.jpg
PMC9463754_02_PAMJ-42-145-g004.jpg
F4
CT Scan of the chest showed bilateral pleural effusion with partial atelectasis of both lungs right: 4.7L, left: 1.5L with thick pericardium about 6.9 mm (Figure 4), the pericardial tube was in situ, but no evidence of pericardial effusion.
H & E stain slide of the pericardium
PAMJ-42-145-g005.jpg
PMC9463754_02_PAMJ-42-145-g005.jpg
F5
Histopathology analysis of Pericardial tissue showed: H & E stain showed mixed chronic inflammation and granulation tissue (Figure 5).
ZN stain histopathology slide of the pericardium
PAMJ-42-145-g006.jpg
PMC9463754_02_PAMJ-42-145-g006.jpg
F6
Impression: non-specific chronic inflammation of the pericardium ZN Stain showed a thick fibrous wall of the pericardium with fibroblast proliferation and mononuclear cells infiltration but no rod-shaped Bacilli for Mycobacterium tuberculosis indicating ZN stain is negative (Figure 6).