Positive Interferon-Gamma Release Assay Leading to a Diagnosis of Mycobacterium tuberculosis Pericarditis in Pregnancy

BACKGROUND: Tuberculosis during pregnancy is associated with increased complications. The wide range of presentations among patients with extrapulmonary tuberculosis can make diagnosis and treatment difficult. CASE: We present the case of a patient with Mycobacterium tuberculosis pericarditis presenting in pregnancy with recurrent pericardial effusions. The diagnosis of active tuberculosis was made and treatment initiated after a positive interferon-gamma release assay and granulomatous pericardial pathology despite negative tuberculin skin testing. Culture of pericardial tissue obtained by pericardectomy confirmed the diagnosis 1 month after initiation of treatment. CONCLUSION: This case report demonstrates the use of interferon-gamma release assay in diagnosing tuberculosis among high-risk pregnant patients. Although limited by expense and minimal experience in pregnancy, these assays may be useful to screen for tuberculosis in high-risk pregnant populations.