The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV

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dc.contributor.authorReuter H.
dc.contributor.authorBurgess L.J.
dc.contributor.authorSchneider J.
dc.contributor.authorVan Vuuren W.
dc.contributor.authorDoubell A.F.
dc.date.accessioned2011-05-15T16:16:32Z
dc.date.available2011-05-15T16:16:32Z
dc.date.issued2006
dc.description.abstractAims: To establish the influence of human immunodeficiency virus (HIV) infection on the histopathological features of patients presenting with tuberculous pericarditis. Methods and results: A prospective study was carried out at Tygerberg Academic Hospital, South Africa; 36 patients with large pericardial effusions had open pericardial biopsies under general anaesthesia and were included in the study. Patients underwent pericardiocentesis, followed by daily intermittent catheter drainage; a comprehensive diagnostic work-up (including histopathology of the pericardial tissue) was also performed. Histological tuberculous pericarditis was diagnosed according to predetermined criteria. Tuberculous pericarditis was identified in 25 patients, five of whom were HIV+. The presence of granulomatous inflammation (with or without necrosis) and/or Ziehl-Neelsen positivity yielded the best test results (sensitivity 64%, specificity 100% and diagnostic efficiency 75%). Conclusions: Co-infection with HIV impacts on the histopathological features of pericardial tuberculosis and leads to a decrease in the sensitivity of the test. In areas which have a high prevalence of tuberculosis, the combination of a sensitive test such as adenosine deaminase, chest X-ray and clinical features has a higher diagnostic efficiency than pericardial biopsy in diagnosing tuberculous pericarditis. © 2006 Blackwell Publishing Limited.
dc.description.versionArticle
dc.identifier.citationHistopathology
dc.identifier.citation48
dc.identifier.citation3
dc.identifier.issn03090167
dc.identifier.other10.1111/j.1365-2559.2005.02320.x
dc.identifier.urihttp://hdl.handle.net/10019.1/13822
dc.subjectadenosine deaminase
dc.subjectarticle
dc.subjectclinical feature
dc.subjectclinical trial
dc.subjectcontrolled clinical trial
dc.subjectcontrolled study
dc.subjectgeneral anesthesia
dc.subjectgranulomatous inflammation
dc.subjectheart muscle biopsy
dc.subjecthistopathology
dc.subjecthuman
dc.subjectHuman immunodeficiency virus
dc.subjectHuman immunodeficiency virus infection
dc.subjecthuman tissue
dc.subjectintermittent catheterization
dc.subjectmajor clinical study
dc.subjectmuscle necrosis
dc.subjectpericardial effusion
dc.subjectpericardiocentesis
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectsensitivity and specificity
dc.subjectSouth Africa
dc.subjectsurgical drainage
dc.subjectthorax radiography
dc.subjecttuberculosis
dc.subjectuniversity hospital
dc.subjectAIDS related complex
dc.subjectbiopsy
dc.subjectHuman immunodeficiency virus 1
dc.subjectisolation and purification
dc.subjectmicrobiology
dc.subjectMycobacterium tuberculosis
dc.subjectpathology
dc.subjectpericarditis
dc.subjectpericardium
dc.subjectvirology
dc.subjectHuman immunodeficiency virus
dc.subjectAdenosine Deaminase
dc.subjectAIDS-Related Opportunistic Infections
dc.subjectBiopsy
dc.subjectHIV Infections
dc.subjectHIV-1
dc.subjectHumans
dc.subjectMycobacterium tuberculosis
dc.subjectPericarditis, Tuberculous
dc.subjectPericardium
dc.subjectProspective Studies
dc.subjectSensitivity and Specificity
dc.titleThe role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV
dc.typeArticle
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