Fibrinofibrous pericarditis mimicking a pericardial tumor

Primary pericardial disease is rare in children. The clinical features usua lly reflect limited venous return and cardiac output. Tuberculous pericardi tis is the leading cause of pericardial disease in developing nations. A de finitive diagnosis in children is frequently difficult and the manifestatio ns are protean. We report a 10-month-old. girl with fibrinofibrous pericard itis that manifested as constrictive pericarditis with prolonged fever, hep atomegaly, edema, and poor appetite. Echocardiography shelved a solid mass that originated from the thickened pericardium and compressed the whole hea rt. In contrast, computed tomography revealed pericardial thickening with f luid collection. The symptoms and signs dramatically improved after surgica l pericardiectomy. Pathologic analysis confirmed the diagnosis of tuberculo us fibrinofibrous pericarditis. The patient received a 1-year course of ant ituberculosis therapy and has remained symptom free for 2 years. We suggest that a discrepancy between echocardiography and computed tomography (CT) f indings might indicate a diagnosis of fibrinofibrous pericarditis.