[Tuberculous pericarditis. Ten years experience].
We review the clinical files of patients who entered the Regional General Hospital No. 20 IMSS in the City of Tijuana Mexico between May 1994 and May 2004 with diagnosis of primary acute pericardial disease. Patients diagnosed as having active tuberculous pericardial effusion were eligible for the study. Twenty-one were included in the study (14 men and 7 women). The aged ranged from 16 to 48 years (mean 36 years). The diagnosis was made by the following studies: identification of tubercle bacilli in the pericardial fluid or tissue (n = 4), identification of caseating granulomas in the pericardium or elsewhere (n = 2), positive culture for Mycobacterium tuberculosis in pericardial fluid (n = 8), in pleural fluid (n = 1), sputum culture (n = 3), gastric aspirate samples (n = 1), lymph node biopsy (n = 1), and pericardial effusion without obvious cause, responding to antituberculous therapy (n = 5). The clinical, laboratory, electrocardiography, radiographic, and echocardiography features were analyzed. We review in each patient follow-up, pericardial fluid cytology, and pericardial biopsy, if available. All patients had pericardial effusion; nine (42.8%) patients had cardiac tamponade. Pericardiocentesis was performed in 16 patients, "therapeutic" pericardiocentesis was performed in 43.7%, and "diagnostic" pericardiocentesis was performed in 56.2% all cases. Constrictive pericarditis developed in two patients, all required partial pericardiectomy. All patients received triple antituberculous chemotherapy. No patient died.
Servicio de Cardiología, Hospital General Regional No. 20 del IMSS, Tijuana Baja California, México. julioalbaguilar@hotmail.com
Julio A
JA
Aguilar
Carmen
C
Summerson
Enrique
E
González Montoya
Gregorio
G
González González
Juan Antonio
JA
López Corvala
Rocío
R
Jiménez Godínez
María del Carmen
Mdel C
Granda
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010495:Pericarditis, Tuberculous / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors