<![CDATA[Background: Pericardial effusion is a rare case, yet lethal if the treatment is not promptly given. Mycobacterium tuberculosis (MTB) is the leading cause of pericardial effusion in countries with high morbidity rate of tuberculosis, such as Indonesia. Generally, the infection happens in immunocompromised patients. Case presentation: This case report presented a 43-year-old female patient without comorbidities with worsening dyspnea exacerbated by dehydration due to acute diarrhea. The radiology imaging revealed the presence of cardiomegaly and pneumonia, meanwhile echocardiography revealed massive pericardial effusion. The pericardiocentesis result showed a negative Xpert TB result; however, elevated adenosine deaminase (ADA) and Staphylococcus aureus in the fluid culture were found. Antibiotic was given according to the culture sensitivity result as well as antituberculosis agents. Conclusion: From this case report, it is concluded that pericardial fluid culture is essential in improving diagnosis since coinfection can occur even to immunocompetent hosts. Immediate and appropriate management will reduce the fatal complication of cardiac tamponade.]]>
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