Disseminated Tuberculosis With Pericardial Effusion and Early Tamponade: A Case Report.

Tuberculous pericarditis is a rare but life-threatening complication of tuberculosis (TB), often presenting with nonspecific symptoms and leading to delayed diagnosis. This case report describes a 26-year-old male with disseminated TB involving the pericardium, pleura, and mediastinal lymph nodes, complicated by early cardiac tamponade. Despite the presence of tamponade physiology, the patient was successfully managed with anti-TB therapy and corticosteroids without invasive intervention. Diagnostic challenges, including the role of imaging, fluid analysis, and molecular testing, are discussed. The case highlights the importance of early diagnosis, timely initiation of anti-TB therapy, and the potential for non-interventional management in select cases. Clinical improvement and resolution of tamponade physiology on follow-up echocardiography underscore the efficacy of medical therapy in preventing complications such as constrictive pericarditis. This report emphasizes the need for a high index of suspicion in TB-endemic regions and the value of individualized treatment approaches.