{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:02:49Z","timestamp":1756339369416,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Extrapulmonary tuberculosis (EPTB) is common in HIV-infected patients, especially at lower CD4 cell counts, yet is often difficult to diagnose with certainty. A 35-year-old man presented with dyspnoea and constitutional symptoms of tuberculosis (TB). Laboratory investigations included a positive HIV test and a CD4 cell count of 138\u2005cells\/\u03bcL. Chest radiography revealed a globular-shaped heart and bilateral pleural effusions, while echocardiography confirmed a massive pericardial effusion. The new Xpert MTB\/RIF (Xpert) assay detected rifampicin-sensitive <jats:italic>Mycobacterium tuberculosis<\/jats:italic> in pericardial as well as sputum samples. Smear of the pericardial sample was negative. The patient was started on anti-TB treatment and is presently well. He will initiate antiretroviral therapy after 4\u20136\u2005weeks. To the best of our knowledge, this is the first case report of EPTB diagnosed on pericardial fluid using the Xpert assay in Africa. This report also summarises the use of this assay in the diagnosis of EPTB in HIV-associated TB.<\/jats:p>","DOI":"10.1136\/bcr-2013-200615","type":"journal-article","created":{"date-parts":[[2013,8,28]],"date-time":"2013-08-28T07:35:22Z","timestamp":1377675322000},"page":"bcr2013200615","source":"Crossref","is-referenced-by-count":3,"title":["Identification of <i>Mycobacterium tuberculosis<\/i> from pericardial fluid using the new Xpert MTB\/RIF assay"],"prefix":"10.1136","volume":"2013","author":[{"given":"Ashar Vijay","family":"Dhana","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Helen Joseph Academic Hospital, Johannesburg, Gauteng, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Howell","sequence":"additional","affiliation":[{"name":"Right to Care, Themba Lethu Clinic, Johannesburg, Gauteng, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Sanne","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Spencer","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Helen Joseph Academic Hospital, Johannesburg, Gauteng, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,8,28]]},"reference":[{"key":"2025082700425910000_2013.aug28_1.bcr2013200615.1","unstructured":"WHO. Global tuberculosis report 2012. Geneva, Switzerland: World Health Organization, 2012."},{"key":"2025082700425910000_2013.aug28_1.bcr2013200615.2","unstructured":"WHO. Policy statement: automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB\/RIF system. Geneva, Switzerland: World Health Organization, 2011."},{"key":"2025082700425910000_2013.aug28_1.bcr2013200615.3","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.ijid.2008.11.013","article-title":"HIV-associated extrapulmonary tuberculosis in Thailand: epidemiology and risk factors for death","volume":"2013","author":"Kingkaew","year":"2009","journal-title":"Int J Infect Dis"},{"key":"2025082700425910000_2013.aug28_1.bcr2013200615.4","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1586\/eri.12.43","article-title":"Diagnosis of extrapulmonary tuberculosis using the Xpert((R)) MTB\/RIF assay","volume":"2013","author":"Lawn","year":"2012","journal-title":"Expert Rev Anti Infect Ther"},{"key":"2025082700425910000_2013.aug28_1.bcr2013200615.5","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1183\/09031936.00176311","article-title":"Clinical validation of Xpert MTB\/RIF for the diagnosis of extrapulmonary 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