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[Tuberculous pericarditis. A case reported and a brief review].

Abstract
Pericarditis in patients with tuberculosis is estimated from one to eight percent. The tuberculosis is considered endemic in developing countries and tuberculous pericarditis is found frequently in patients with the Acquired Immunodeficiency Syndrome (AIDS). This entity is characterized by mediastinal or hilar lymph nodes, sternum or spine with retrograde tracheobronchial extension. Spread may also take place by the hematogenous route. The beginning can be suddenly, like an unknown pericarditis, with cough, dyspnea, chest pain, ankle edema, fever, tachycardia, and night sweats. Clinical examination shows pericardial friction rub, liver congestion, ascites, edema and low intensity cardiac noise. Chest radiograph shows cardiomegaly. The two-dimensional echocardiography verifies pericardial effusion. The PPD skin test can be negative in 30% by the presence of anergy. Definitive diagnosis is the demonstration of pericardium inflammatory granulomas and the presence of acid-alcohol resistant bacilli in the pericardial biopsy. We conclude that the tuberculous pericarditis diagnosis should be established by clinical suspicion, two-dimensional echocardiography and pericardiocentesis and later pericardiectomy must be practiced as soon as possible before receiving pharmacological treatment with triple drug therapy and steroids.
AuthorsJesús Sida-Díaz, Juan Carlos Nuñez-Fragoso, Jesús Martínez-Burciaga, Alberto Valles-Guerrero, Sergio Tránsito Deras-Cabral, Marco Antonio Flores-Ramos, Alejandro Torres-Castorena
JournalRevista medica del Instituto Mexicano del Seguro Social (Rev Med Inst Mex Seguro Soc) 2011 Jan-Feb Vol. 49 Issue 1 Pg. 75-8 ISSN: 0443-5117 [Print] Mexico
Vernacular TitlePericarditis tuberculosa. Informe de un caso y revisión de la literatura.
PMID21513665 (Publication Type: Case Reports, English Abstract, Journal Article, Review)
Topics
  • Aged
  • Female
  • Humans
  • Pericarditis, Tuberculous (diagnosis, therapy)

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