Tuberculous pericarditis

Posted by e-Medical PPT
Incidence low secondary to low incidence of TB in general
Occurs in 1-2% of patients with pulmonary TB
One Spanish study found 4.4% of pulmonary TB patient s had pericarditis
Keep in mind that Spanish (and South African) figures on incidence far exceed that in the USA
A Mayo clinic study found 2% cases of pericarditis in pulmonary TB patients as apposed to a similar study at Mayo fifty years ago
However, parts of the USA have high immigrant populations where TB pericarditis rates are much higher, as established at Baylor in 1990.
TB pericarditis is usually associated with TB somewhere else in body
Usually represent reactivation disease thus a primary infective location usually not found
4 Stages
Do not necessarily occur in order or individually
Dry
Inflammatory process thought secondary to hypersensitivity reaction to tuberculoprotein
Effusive
Serosangiouness fluid with leukocytes and high protein and tubercle bacilli found in low concentration
Pressures consistent with cardiac tamponade are found

Pericarditis caused by tuberculosis is difficult to diagnose, because definitive diagnosis requires culturing Mycobacterium tuberculosis from aspirated pericardial fluid or pericardial biopsy, which requires high technical skill and is often not diagnostic (the yield from culture is low even with optimum specimens). The Tygerberg scoring system helps the clinician to decide whether pericarditis is due to tuberculosis or whether it is due to another cause


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