Clinical Scenario:
A 9-year-old boy is admitted with a 4-week history of low-grade fever, weight loss, and progressive shortness of breath. Examination reveals elevated jugular venous pressure, muffled heart sounds, and hepatomegaly. Chest radiograph shows cardiomegaly, and echocardiography demonstrates a large pericardial effusion. Pericardial fluid analysis reveals lymphocyte predominance, high protein, and elevated ADA.
What is the most appropriate treatment?
A. ATT with steroids
B. Broad-spectrum antibiotics
C. Intravenous immunoglobulin
D. Pericardiocentesis alone
E. Prednisolone alone
Correct answer & Explanation:
Correct Answer: A. ATT with steroids
Explanation
The child has tuberculous pericardial effusion. The recommended treatment is antituberculous therapy (ATT) with adjunctive corticosteroids. Pericardiocentesis is reserved for cardiac tamponade or diagnostic purposes and should not be the sole treatment.
