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Pericarditis is a rare manifestation of tuberculosis. We report the case of a 35-year-old woman admitted for clinical tamponade. The echocardiogram revealed a pericardial effusion of great circumferential abundance with significant respiratory variations and a bilateral pleural effusion of average abundance on chest Xray. The patient underwent emergency pericardial drainage. The initial tuberculosis assessment was negative. The culture of the liquid was positive after 8 days Revealing Rifampicin-Resistant tuberculosis (RR-TB). Therefore, examination of the pericardial fluid is useful in the diagnosis of pericarditis due to RR-TB. The patient was put on a special treatment regimen after consensus, which yielded satisfactory clinical improvement. Our findings suggest that though pericardial tuberculosis remains a rare disease, it is important to consider it as an etiological diagnosis, especially in endemic countries because it's poor therapeutic prognosis. Early diagnosis would allow better management of these cases in order to limit cases of resistance.

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