The management of tuberculous pericardial effusion : experience in 233 consecutive patients
| dc.contributor.author | Reuter, Helmuth | |
| dc.contributor.author | Burgess, Lesley J. | |
| dc.contributor.author | Louw, Vernon J. | |
| dc.contributor.author | Doubell, Anton F. | |
| dc.date.accessioned | 2012-01-23T16:19:47Z | |
| dc.date.available | 2012-01-23T16:19:47Z | |
| dc.date.issued | 2007-02 | |
| dc.description | The original publication is available at http://www.cvja.co.za/ | en_ZA |
| dc.description.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. | en_ZA |
| dc.description.version | Publishers' version | en_ZA |
| dc.format.extent | p. 20-25 | |
| dc.identifier.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. | en_ZA |
| dc.identifier.issn | 1680-0745 (online) | |
| dc.identifier.issn | 1995-1892 (print) | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/19357 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Clinics Cardiv Publishing | en_ZA |
| dc.rights.holder | Cardiovascular Journal of Africa holds the copyright | en_ZA |
| dc.subject | Tuberculous pericardial effusion | en_ZA |
| dc.title | The management of tuberculous pericardial effusion : experience in 233 consecutive patients | en_ZA |
| dc.type | Article | en_ZA |