| Abstract | AIM: We report on the 30-day and one-year outcome of consecutive effusive pericarditis patients, including those with tuberculous pericarditis, over a six-year-period. METHODS AND RESULTS: Patients with large pericardial effusions requiring pericardiocentesis were included in the study after having given written informed consent. Clinical and radiological evaluations were followed by echo-guided pericardiocentesis, and extended daily intermittent drainage via an indwelling pigtail catheter. A standard short-course anti-tuberculous regimen was initiated. A total of 233 patients was included. One hundred and sixty-two patients had pericardial tuberculosis (TB), including 118 (73%) with microbiological and/ or histological evidence of TB and 44 (27%) diagnosed on clinical and supportive laboratory data. Over the six-year period, two patients developed fibrous constrictive pericarditis after receiving adjuvant corticosteroid therapy. The 30-day mortality (8.0%) was statistically higher for HIV-positive patients (corresponding mortality 9.9%) than for HIV-negative patients (6.2%; p = 0.04). The one year all-cause mortality was 17.3%. It was also higher for HIV-positive (22.2%) than for IV-negative patients (12.3%; p = 0.03). Cardiac mortality was equal for HIV-positive and -negative patients. CONCLUSION: Tuberculous pericardial effusions responded well to closed pericardiocentesis and a six-month treatment of antituberculous chemotherapy. The former was effective and safe irrespective of HIV status. |
| Authors | H Reuter, L J Burgess, V J Louw, A F Doubell
(Affiliation: TREAD Research/Cardiology Unit, Tygerberg Hospital and University of Stellenbosch, Parow, Western Cape, South Africa.)
|
| Journal | Cardiovascular journal of South Africa : official journal for Southern Africa Cardiac Society [and] South African Society of Cardiac Practitioners
(Cardiovasc J S Afr)
2007 Jan-Feb
Vol. 18
Issue 1
Pg. 20-5
ISSN: 1015-9657 South Africa |
| PMID | 17392991
(Publication Type: Journal Article)
|
| Chemical References |
- Anti-Infective Agents
- Anti-Inflammatory Agents
- Prednisone
- Trimethoprim-Sulfamethoxazole Combination
|
| Topics |
- Adult
- Analysis of Variance
- Anti-Infective Agents
(therapeutic use)
- Anti-Inflammatory Agents
(therapeutic use)
- CD4 Lymphocyte Count
- Catheters, Indwelling
(adverse effects)
- Drainage
(instrumentation)
- Female
- Follow-Up Studies
- HIV Infections
(complications)
- Humans
- Male
- Middle Aged
- Pericardial Effusion
(immunology, microbiology, mortality, therapy)
- Pericardiectomy
- Pericardiocentesis
(adverse effects, instrumentation)
- Pericarditis, Tuberculous
(complications, immunology, mortality, therapy)
- Prednisone
(therapeutic use)
- South Africa
- Survival Analysis
- Treatment Outcome
- Trimethoprim-Sulfamethoxazole Combination
(therapeutic use)
|
