Tuberculous pericarditis is an infrequent but serious form of tuberculosis.Its diagnosis is difficult and often delayed or not even reached, which results in complications such as constrictive pericarditis with high mortality rates (1).In 2017, there were 10 million cases of active tuberculosis worldwide and 1.3 million related deaths making tuberculosis the leading cause of death by a single pathogen worldwide (2).In Colombia, 13,626 new cases of tuberculosis were reported during 2016 of which 83% (11,338 cases) corresponded to pulmonary tuberculosis and 17% (2,288 cases) to extrapulmonary tuberculosis while 37 cases (1.6%) of these corresponded to tuberculous pericarditis (3).We describe here the case of tuberculous pericarditis in a man with no apparent risk factors to develop the disease, which reinforces the concept that no predisposing condition is necessary to develop tuberculosis (4).A 62-year-old man presented to the emergency room with a history of malaise, fever, cough, dyspnea, and loss of 5 kg of weight in the previous 30 days.His initial assessment showed normal vital signs and no abnormalities in the white blood cell count; the erythrocyte sedimentation rate was 56 mm/h, the C-reactive protein was 10.66 mg/l, and the procalcitonin level was less than 0.5 ng/ml; the serology for HIV was negative.Chest X-rays showed global cardiomegaly with a rounded heart shape (figure 1).The chest tomography evidenced abundant homogeneous and hypodense pericardial effusion, thickening of the pericardial membrane, and enlarged lymph nodes (figure 2).An echocardiogram confirmed the accumulation of approximately 1,300 ml of pericardial effusion without hemodynamic compromise.