Jong Man Kim, et al. presentation in 7% of these cases [5]. Pre-operative puri- fied protein derivative of tuberculin testing is routinely CONFLICTS OF INTEREST performed currently in kidney transplant recipients be- No potential conflict of interest relevant to this article cause Korea is tuberculosis-endemic area. About 45 to 60% of tuberculosis occurs in the first year (median onset time, 9 months) after renal transplantation [6]. Cough, shortness of breath, orthopnea, night sweats, weight loss, and ankle edema are common symptoms in tuberculosis pericarditis. The most common findings are cardiomegaly, pericardial rub, fever, and tachycardia [7]. Our case showed fever, chest discomfort and pain, but oth- er cardiac problems were not present. In our case, cardiac tamponade was rapidly developed by increased peri- cardial effusion with symptoms such as chest discomfort and pain, even though initial echocardiography showed minimal pericardial fluid. The pericardial tuberculosis in- fection was unexpected as there was no risk factor or his- tory of tuberculosis and the radiologic findings of chest X-ray and chest computed tomography were clear. Tuberculosis pericarditis should be considered as the cause of cardiac tamponade in renal transplant recipients, even with the absence of pericardial effusion in the initial study or suggestive history. was reported. REFERENCES 1. 1. Alothman A, Al Abdulkareem A, Al Hemsi B, Issa S, Al Sarraj I, Masoud F. Isolated hepatic tuberculosis in a trans- planted liver. Transpl Infect Dis 2004;6:84-6. 2. 2. Hsu MS, Wang JL, Ko WJ, Lee PH, Chou NK, Wang SS, et al. Clinical features and outcome of tuberculosis in solid organ transplant recipients. Am J Med Sci 2007;334:106-10. 3. 3. Subramanian AK, Nuermberger EL. Tuberculosis in transplant recipients: diagnostic and therapeutic dilemmas. Transpl Infect Dis 2008;10:229-30. 4. 4. Muñoz P, Rodríguez C, Bouza E. Mycobacterium tuber- culosis infection in recipients of solid organ transplants. Clin Infect Dis 2005;40:581-7. 5. 5. Fowler NO. Tuberculous pericarditis. JAMA 1991;266: 99-103. 6. 6. Singh N, Paterson DL. Mycobacterium tuberculosis in- fection in solid-organ transplant recipients: impact and im- plications for management. Clin Infect Dis 1998;27:1266-77. 7. 7. Trautner BW, Darouiche RO. Tuberculous pericarditis: optimal diagnosis and management. Clin Infect Dis 2001; 33:954-61. S42 thesurgery.or.kr