Tuberculous pericarditis in Birmingham.

Gooi, H. C.; Smith, J. Morrison

doi:10.1136/thx.33.1.94

Cited by 51 publications

(18 citation statements)

References 5 publications

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“…58 Antituberculosis chemotherapy increases survival dramatically in tuberculous pericarditis. In the preantibiotic era, mortality was 80% to 90% 59 ; it ranges currently from 8% to 17% in HIV-negative patients 11,23,60,61 and 17% to 34% in HIV-positive individuals. 62 A regimen consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol for at least 2 months, followed by isoniazid and rifampicin (total of 6 months of therapy) has been shown to be highly effective in treating patients with extrapulmonary TB.…”

Section: Empirical Antituberculosis Chemotherapymentioning

confidence: 99%

Tuberculous Pericarditis

2005

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Background-The incidence of tuberculous pericarditis is increasing in Africa as a result of the human immunodeficiency virus (HIV) epidemic. The primary objective of this article was to review and summarize the literature on the pathogenesis, diagnosis, and management of tuberculous pericarditis. Methods and Results-We searched MEDLINE (January 1966 to May 2005 and the Cochrane Library (Issue 1, 2005) for information on relevant references. A "definite" diagnosis of tuberculous pericarditis is based on the demonstration of tubercle bacilli in pericardial fluid or on a histological section of the pericardium; "probable" tuberculous pericarditis is based on the proof of tuberculosis elsewhere in a patient with otherwise unexplained pericarditis, a lymphocytic pericardial exudate with elevated adenosine deaminase levels, and/or appropriate response to a trial of antituberculosis chemotherapy. Treatment consists of the standard 4-drug antituberculosis regimen for 6 months. It is uncertain whether adjunctive corticosteroids are effective in reducing mortality or progression to constriction. Surgical resection of the pericardium remains the appropriate treatment for constrictive pericarditis. The timing of surgical intervention is controversial, but many experts recommend a trial of medical therapy for noncalcific pericardial constriction, and pericardiectomy in nonresponders after 4 to 8 weeks of antituberculosis chemotherapy.

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Section: Empirical Antituberculosis Chemotherapymentioning

confidence: 99%

Tuberculous Pericarditis

2005

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“…Seven of 11 cases (63.6%) of benign pericardial thickening in our study were associated with tuberculous pericarditis (six cases of smooth and one case of irregular thickening). The incidence of tuberculous pericarditis ranges from 8% to 17% among HIV-negative persons [33,35,36] but from 17% to 34% among HIV-positive persons [37]. Antituberculosis chemotherapy dramatically improves survival among patients with tuberculosis pericarditis.…”

Section: Ct Of Pericardial Effusionmentioning

confidence: 99%

CT Findings in Patients With Pericardial Effusion: Differentiation of Malignant and Benign Disease

Sun

Park

Kang³

2010

American Journal of Roentgenology

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“…During the last 50 years, the incidence of tuberculous pericarditis has fallen steadily [1, 2]. On the other hand, atypical forms of mycobacteria, along with classic tubercle bacilli, have increasingly appeared mainly in immunocompromised patients [3].…”

Section: Introductionmentioning

confidence: 99%

Relevance of Adenosine Deaminase and Lysozyme Measurements in the Diagnosis of Tuberculous Pericarditis

et al. 2000

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Objective: To assess the value of pericardial fluid adenosine deaminase (ADA) and pericardial lysozyme (Lys) as tools in diagnosing tuberculous pericarditis. Methods: Forty-one patients (age range 17–77 years) with significant pericardial effusion were included in the study. Diagnostic pericardiocentesis and pericardial biopsy were performed while serum and pericardial fluid ADA and Lys were measured in all patients. Grouping of patients resulted as follows: group I = 7 patients with tuberculous pericarditis; group II = patients with neoplastic pericarditis; group III = 30 patients with idiopathic pericarditis. Results: Pairwise multiple comparison procedures revealed a significant difference of ADA in group I versus group III (p < 0.05) but not versus group II. Furthermore, pericardial Lys in group I was higher than in groups II and III (p < 0.05). A strong correlation between pericardial ADA and Lys was found (r = 0.733, p = 0.01) for all the patients. Receiver operating curves showed a value of 72 U/l as cutoff point of pericardium ADA, with a sensitivity of 100% and a specificity of 94% in the diagnosis of tuberculous pericarditis. Similarly for pericardial Lys, a value of 6.5 µg/dl had a sensitivity and specificity of 100 and 91.17%, respectively. Conclusions: Both measurements of pericardial ADA and Lys need to be taken into account when attempting the early diagnosis of tuberculous pericarditis.

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Tuberculous pericarditis in Birmingham.

Cited by 51 publications

References 5 publications

Tuberculous Pericarditis

Tuberculous Pericarditis

CT Findings in Patients With Pericardial Effusion: Differentiation of Malignant and Benign Disease

Relevance of Adenosine Deaminase and Lysozyme Measurements in the Diagnosis of Tuberculous Pericarditis

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