Cardiac tamponade and massive pleural effusion in a young COVID-19-positive adult.

COVID-19 has a broad spectrum of cardiac manifestations, and cardiac tamponade leading to cardiogenic shock is a rare presentation. A 30-year-old man with a history of COVID-19-positive, reverse transcription polymerase chain reaction (RT-PCR) done 1 week ago and who was home-quarantined, came to the emergency department with palpitations, breathlessness and orthopnoea. His ECG showed sinus tachycardia with low-voltage complexes, chest X-ray showed cardiomegaly and left pleural effusion and two-dimensional echocardiography showed large pericardial effusion with features suggestive of cardiac tamponade. He was taken up for emergency pericardiocentesis which showed haemorrhagic pericardial fluid. Intercostal drainage insertion was done for left-sided large pleural effusion. After ruling out all the other causes for haemorrhagic pericardial effusion, the patient was started on colchicine, steroids, ibuprofen and antibiotics to which he responded. Both pericardial and pleural effusions resolved completely on follow-up.

Coinfection of SARS-CoV-2 and MTB: how not to miss the wood for the trees.

Scarce data exist about the coinfection of SARS-CoV-2 and Mycobacterium tuberculosis (MTB). A young woman who was undergoing treatment for multiple sclerosis was brought to our hospital with a COVID-19 positive status. On further evaluation, her chest X-ray showed right upper and mid-zone opacity, which lead to the suspicion of MTB. Her sputum came positive for acid-fast bacilli (AFB) staining and cartridge-based nucleic acid amplification test (CBNAAT) confirmed it, and rifampicin resistance was not detected. She was started on an antitubercular regimen. She was discharged, and by the end of the intensive phase of treatment, her symptoms subsided, but her sputum CBNAAT still showed the presence of TB bacillus.