Tuberculous pericarditis : experience in a community hospital

  • Fernando Peixoto Ferraz de Campos Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brazil.
  • Aloísio Felipe-Silva Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brazil.
  • Leonardo Gomes Fonseca Hospital das Clínicas – Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
  • Antônio Fernando Barros de Azevedo Filho Hospital das Clínicas – Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
  • Luiz Fernando Seguro Faculdade de Medicina Universidade de São Paulo, São Paulo/SP, Brazil.
Keywords: Tuberculosis, Pericarditis, tuberculous, Diagnosis.

Abstract

Tuberculosis is a major public health problem worldwide. In Butantan district of São Paulo city, the average incidence over the last 7 years was 47.7 new cases/100,000 inhabitants. Tuberculous pericarditis is a serious form of extrapulmonary
tuberculosis in which diagnosis is often difficult. Diagnosis needs to be reached fast and accurately once tuberculous pericarditis has high morbimortality rates if untreated. We report the experience of a community hospital on tuberculous
pericarditis with emphasis on the clinical presentation and diagnostic procedures. From 2003 to 2010, 59 patients were diagnosed with pericarditis, 6 (10.16%) of which had tuberculous pericarditis. Demographic, clinical, imaging,
laboratorial, microbiological and histological data were reviewed. There were 4 female (66.7%) and 2 male (33.3%) patients. Age ranged from 17 to 62 years (median= 25.5). One patient (17%) had HIV co-infection. Five patients (83.3%) had cardiac tamponade on Echocardiogram. Histopathology was confirmatory in 4 cases (66.7%) while cultures were positive in 2 cases (33.3%). Four patients (66.7%) had definite and 2 (33.3%) had probable diagnosis of tuberculous pericarditis.
One patient (17%) died during admission. Reuter´s diagnostic index was ≥6 in 5 patients (83.3%). We concluded that the clinical picture, Reuter´s diagnostic index, signs of cardiac tamponade on Echocardiogram and the pericardium
biopsy were the most important features for the diagnosis of tuberculous pericarditis.

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Author Biographies

Fernando Peixoto Ferraz de Campos, Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brazil.
Department of Internal Medicine of the Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brazil.
Aloísio Felipe-Silva, Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brazil.
Service of Anatomic Pathology of the Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brazil.
Leonardo Gomes Fonseca, Hospital das Clínicas – Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
Department of Internal Medicine of the Hospital das Clínicas – Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
Antônio Fernando Barros de Azevedo Filho, Hospital das Clínicas – Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
Department of Internal Medicine of the Hospital das Clínicas – Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
Luiz Fernando Seguro, Faculdade de Medicina Universidade de São Paulo, São Paulo/SP, Brazil.
Instituto do Coração – Hospital das Clínicas – Faculdade de Medicina Universidade de São Paulo, São Paulo/SP, Brazil.
Published
2011-03-08
How to Cite
de Campos, F., Felipe-Silva, A., Fonseca, L., Filho, A., & Seguro, L. (2011). Tuberculous pericarditis : experience in a community hospital. Autopsy and Case Reports, 1(1). https://doi.org/10.4322/acr.2016.011
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Article