Tuberculous pericarditis: three cases and brief review.
Tuberculous pericarditis is a form of extrapulmonary tuberculosis that is considered unusual in western coun-tries. Diagnosis is often challenging, while proper treatment has a major impact on prognosis. We present three interesting cases, with complicated or unusual manifestations of tuberculous pericarditis: a patient with cardiac tamponade as the initial manifestation of tuberculosis; a patient progressing to constriction despite adequate treatment; and a patient receiving anti-TNFalpha, who developed pericarditis in the context of immune reconstitution inflammatory syndrome. We briefly review the clinical features of tuberculous pericarditis, whilst our main focus is on the available diagnostic techniques and treatment aspects. In conclusion, tuberculous pericarditis remains an active thread in the western world. A high index of suspicion combined with the use of all available diagnostic techniques are important to increase diagnostic yield. Prompt and effective treatment is essential to reduce morbidity and mortality.
Metaxas
E I
EI
Pulmonary Medicine Department, Evaggelismos General Hospital, Athens, Greece. eumetaxas@yahoo.gr
Kotsifas
K
K
Tatsis
G
G
Simpsiris
P
P
Ntanos
I
I
Tsoukalas
G
G
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D002305:Cardiac Tamponade / Q000150:complications* / Q000601:surgery; D004359:Drug Therapy, Combination; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications*; D007155:Immunologic Factors / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010495:Pericarditis, Tuberculous / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects
D000995:Antitubercular Agents; D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha