Value of Tygerberg Scoring for the Diagnosis and Management of Tuberculous Pericarditis

Achnes Pangaribuan; Kurniyanto; Donnie  Lumban Gaol; Yunus Tanggo

doi:10.33541/mkvol34iss2pp60

Achnes Pangaribuan Department of Internal Medicine General Hospital
Kurniyanto Department of Internal Medicine Faculty of Medicine Christian University of Indonesia
Donnie Lumban Gaol Department of Internal Medicine Faculty of Medicine Christian University of Indonesia
Yunus Tanggo Department of Internal Medicine Faculty of Medicine Christian University of Indonesia

DOI: https://doi.org/10.33541/mkvol34iss2pp60

Abstrak

Abstract Extra pulmonary tuberculosis occurs in 20% of patients with tuberculosis. Tuberculosis pericarditis is seen in 1-8% of these patients. Tuberculosis has been reported to be the cause of acute pericarditis in 60-80% of the patients in the developing world. We reported a case of 19 years old male who presented with right chest pain, cough, breathlessness, night sweat, fever, fatigue, and weight loss. From the physical examination, jugular venous pressure was high and on auscultation, the heart sounds were muffled and associated with a pericardial rub. The chest x-ray revealed enlargement of cardiac silhouette. Transthoracic echocardiography showed pericardial effusion, and mantoux tuberculin skin test were positive. Since the pericardiocentesis is not feasible in our hospital, the tygerberg tuberculous pericarditis score was applied. Furthermore, patients were given anti-TB treatment, and showed a good response to treatment.
Key words: extra pulmonary tuberculosis, tuberculous pericarditis, tygerberg score

Abstrak Tuberkulosis dapat menyebabkan kelainan di luar paru. Prevalensinya berkisar sekitar 20% dan dapat menyebabkan kelainan diberbagai organ seperti perikarditis pada jantung. Tuberkulosis telah dilaporkan menjadi penyebab perikarditis akut pada 60-80% pasien di negara berkembang. Pada tulisan ini dilaporkan seorang laki-laki berusia 19 tahun dengan keluhan nyeri dada kanan disertai batuk, sesak nafas, keringat malam, lemas, dan penurunan berat badan. Pada pemeriksaan fisik ditemukan peningkatan tekanan vena jugularis, dan pada auskultasi ditemukan bising jantung sesuai dengan gesekan perikardium. Pada pemeriksaan foto polos dada ditemukan pembesaran ruang jantung. Pada ekokardiografi ditemukan efusi perikardial. Karena perikardial drainase tidak dapat dilakukan, diterapkan skor tygerberg untuk diagnosis perikarditis tuberkolosis. Selanjutnya pasien diberi pengobatan anti TB, dan menunjukkan respons yang baik terhadap pengobatan.
Kata kunci: tuberkulosis ekstra pulmoner, perikarditis tuberkulosis, skor tygerberg