A 42-year-old man presented with cough and nocturnal sweats since 3 weeks. He was being treated for pulmonary and lymph node tuberculosis (TB) since 5 months, and had improved both clinically and radiologically. Current treatment consisted of isoniazid and rifampicin. Pulmonary imaging revealed bilateral pleural effusions (Fig. 1A) and cardiac ultrasound showed constrictive pericarditis (Fig. 1B and C). After extensive work-up, a working diagnosis of TB pericarditis was made. Methylprednisolone 48 mg/day was started and levofloxacin was added to the TB regimen.
