DILATED CARDIOMYOPATHY WITH CAVITATORY TB
Author:
Pediatric Oncall
Question
A 1½ years old girl presented with cough for 15 days and breathlessness for 8 days in November 2009. She was treated for pulmonary TB in April 2009 for 6 months. Grandfather had tuberculosis 1 year back and had received antituberculous therapy {ATT} for same. On examination, weight was 7.2 kg and height was 75 cms. Air entry was decreased in right supra-mammary region and she had bilateral crepts along with cardiomegaly. Her Chest X-Ray showed right paracardiac laziness with cardiomegaly. CT chest showed consolidation in right upper lobe with cavitating nodule in right middle lobe with few mediastinal hilar lymph nodes. Echocardiography showed dilated cardiomyopathy with non-compacted left ventricle and fractional shortening of 20 percent with ejection fraction of 40 percent. Her serum calcium, ammonia, CPK were normal. Bronchoalveolar lavage did not grow any acid fast bacilli after 6 weeks of culture. She was started on Category 2 of ATT along with Furosemide and enalapril.
What is the cause of dilated cardiomyopathy_? Can TB cause dilated cardiomyopathy_?
Expert Opinion :
Yes, selenium deficiency is a possibility. We did give her micronutrient supplements but her echo remained the same.