The management of tuberculous pericardial effusion : experience in 233 consecutive patients
Date
2007-02
Authors
Reuter, Helmuth
Burgess, Lesley J.
Louw, Vernon J.
Doubell, Anton F.
Journal Title
Journal ISSN
Volume Title
Publisher
Clinics Cardiv Publishing
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 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.
Description
The original publication is available at http://www.cvja.co.za/
Keywords
Tuberculous pericardial effusion
Citation
Reuter, 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.