Abstract
INTRODUCTION: Due to its rarity and severity, tuberculous polyseritis is a diagnostic challenge that can lead to serious complications. Portal vein thrombosis is an uncommon complication that is often overlooked. This case report illustrates this association in an immunocompetent patient. OBSERVATION: A 31-year-old male gold miner with a history of tuberculosis infection was admitted with dyspnea, chest pain, a productive cough, and signs of tuberculosis impregnation that had developed over the course of two months. Physical examination revealed massive left pleurisy, moderate ascites, and pericardial effusion in the pre-tamponade stage. An abdominal ultrasound revealed partial thrombosis of the portal vein. Laboratory tests showed inflammatory anemia, leukopenia, and exudative effusions. Mycobacterium tuberculosis DNA was detected in pleural and peritoneal samples by GeneXpert. A diagnosis of tuberculous polyseritis complicated by portal vein thrombosis was made. The patient received four-drug antituberculosis therapy, as well as pleural and pericardial drainage and acetylsalicylic acid to treat his portal vein thrombosis. The outcome was favorable, with clinical resolution occurring in two months and full recovery occurring in six months. CONCLUSION: This case highlights the importance of considering tuberculosis as a possible cause of venous thrombosis, even in immunocompetent individuals. Early diagnosis and appropriate management improve the prognosis.