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The management of tuberculous pericardial effusion : experience in 233 consecutive patients

dc.contributor.authorReuter, Helmuth
dc.contributor.authorBurgess, Lesley J.
dc.contributor.authorLouw, Vernon J.
dc.contributor.authorDoubell, Anton F.
dc.date.accessioned2012-01-23T16:19:47Z
dc.date.available2012-01-23T16:19:47Z
dc.date.issued2007-02
dc.identifier.citationReuter, H., Burgess, L.J ., Louw, V. J. & Doubell, A.F. 2007. The management of tuberculous pericardial effusion: experience in 233 consecutive patients. Cardiovascular Journal of South Africa, 18(1):20-25.en_ZA
dc.identifier.issn1680-0745 (online)
dc.identifier.issn1995-1892 (print)
dc.identifier.urihttp://hdl.handle.net/10019.1/19357
dc.descriptionThe original publication is available at http://www.cvja.co.za/en_ZA
dc.description.abstractAim: 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 oneyear all-cause mortality was 17.3%. It was also higher for HIV-positive (22.2%) than for HIV-negative patients (12.3%; p=0.03). Cardiac mortality was equal for HIVpositive 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.en_ZA
dc.format.extentp. 20-25
dc.language.isoen_ZAen_ZA
dc.publisherClinics Cardiv Publishingen_ZA
dc.subjectTuberculous pericardial effusionen_ZA
dc.titleThe management of tuberculous pericardial effusion : experience in 233 consecutive patientsen_ZA
dc.typeArticleen_ZA
dc.description.versionPublishers' versionen_ZA
dc.rights.holderCardiovascular Journal of Africa holds the copyrighten_ZA


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