1921
Volume 83, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

We report a case of human immunodeficiency virus–associated pericardial tuberculosis complicated by cardiac tamponade. Emergency management and subsequent therapeutic interventions are described and then discussed with particular focus on resource-limited settings. The paucity of evidence to support clinical decisions is emphasized and the need for well designed diagnostic and therapeutic studies is highlighted.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.2010.10-0271
2010-12-06
2018-12-13
Loading full text...

Full text loading...

/deliver/fulltext/14761645/83/6/1311.html?itemId=/content/journals/10.4269/ajtmh.2010.10-0271&mimeType=html&fmt=ahah

References

  1. World Health Organization, 2009. Global Tuberculosis Control: Epidemiology, Planning, Financing: WHO report 2009. Geneva: World Health Organization. [Google Scholar]
  2. Mayosi BM, Wiysonge CS, Ntsekhe M, Gumedze F, Volmink JA, Maartens G, Aje A, Thomas BM, Thomas KM, Awotedu AA, Thembela B, Mntla P, Maritz F, Blackett KN, Nkouonlack DC, Burch VC, Rebe K, Parrish A, Sliwa K, Vezi BZ, Alam N, Brown BG, Gould T, Visser T, Magula NP, Commerford PJ, , 2008. Mortality in patients treated for tuberculous pericarditis in sub-Saharan Africa. S Afr Med J 98: 3640. [Google Scholar]
  3. Wallrauch C, Heller T, Lessells R, Kekana M, Barnighausen T, Newell ML, , 2010. High uptake of HIV testing for tuberculosis patients in an integrated primary health care HIV/TB programme in rural KwaZulu-Natal. S Afr Med J 100: 146147.[Crossref] [Google Scholar]
  4. Mayosi BM, Wiysonge CS, Ntsekhe M, Volmink JA, Gumedze F, Maartens G, Aje A, Thomas BM, Thomas KM, Awotedu AA, Thembela B, Mntla P, Maritz F, Blackett KN, Nkouonlack DC, Burch VC, Rebe K, Parish A, Sliwa K, Vezi BZ, Alam N, Brown BG, Gould T, Visser T, Shey MS, Magula NP, Commerford PJ, , 2006. Clinical characteristics and initial management of patients with tuberculous pericarditis in the HIV era: the Investigation of the Management of Pericarditis in Africa (IMPI Africa) Registry. BMC Infect Dis 6: 2.[Crossref] [Google Scholar]
  5. World Health Organization, 2007. Improving the Diagnosis and Treatment of Smear-Negative Pulmonary and Extrapulmonary Tuberculosis among Adults and Adolescents. Recommendations for HIV-Prevalent and Resource-Constrained Settings. Geneva: World Health Organization. [Google Scholar]
  6. George S, Salama AL, Uthaman B, Cherian G, , 2004. Echocardiography in differentiating tuberculous from chronic idiopathic pericardial effusion. Heart 90: 13381339.[Crossref] [Google Scholar]
  7. Heller T, Wallrauch C, Lessells RJ, Goblirsch S, Brunetti E, , 2010. Short course for focused assessment with sonography for human immunodeficiency virus/tuberculosis: preliminary results in a rural setting in South Africa with high prevalence of human immunodeficiency virus and tuberculosis. Am J Trop Med Hyg 82: 512515.[Crossref] [Google Scholar]
  8. Reuter H, Burgess LJ, Doubell AF, , 2005. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect 133: 393399.[Crossref] [Google Scholar]
  9. Reuter H, Burgess L, van Vuuren W, Doubell A, , 2006. Diagnosing tuberculous pericarditis. QJM 99: 827839.[Crossref] [Google Scholar]
  10. Hakim JG, Ternouth I, Mushangi E, Siziya S, Robertson V, Malin A, , 2000. Double blind randomised placebo controlled trial of adjunctive prednisolone in the treatment of effusive tuberculous pericarditis in HIV seropositive patients. Heart 84: 183188.[Crossref] [Google Scholar]
  11. Tuon FF, Litvoc MN, Lopes MI, , 2006. Adenosine deaminase and tuberculous pericarditis–a systematic review with meta-analysis. Acta Trop 99: 6774.[Crossref] [Google Scholar]
  12. Reuter H, Burgess LJ, Louw VJ, Doubell AF, , 2007. The management of tuberculous pericardial effusion: experience in 233 consecutive patients. Cardiovasc J S Afr 18: 2025. [Google Scholar]
  13. World Health Organization, Stop TB Department, 2010. Treatment of Tuberculosis: Guidelines. Geneva: World Health Organization. [Google Scholar]
  14. Khan FA, Minion J, Pai M, Royce S, Burman W, Harries AD, Menzies D, , 2010. Treatment of active tuberculosis in HIV-coinfected patients: a systematic review and meta-analysis. Clin Infect Dis 50: 12881299.[Crossref] [Google Scholar]
  15. Strang JI, Kakaza HH, Gibson DG, Allen BW, Mitchison DA, Evans DJ, Girling DJ, Nunn AJ, Fox W, , 1988. Controlled clinical trial of complete open surgical drainage and of prednisolone in treatment of tuberculous pericardial effusion in Transkei. Lancet 2: 759764.[Crossref] [Google Scholar]
  16. Strang JI, Kakaza HH, Gibson DG, Girling DJ, Nunn AJ, Fox W, , 1987. Controlled trial of prednisolone as adjuvant in treatment of tuberculous constrictive pericarditis in Transkei. Lancet 2: 14181422.[Crossref] [Google Scholar]
  17. Mayosi BM, Ntsekhe M, Volmink JA, Commerford PJ, , 2002. Interventions for treating tuberculous pericarditis. Cochrane Database Syst Rev CD000526. [Google Scholar]
  18. National Institutes of Health, 2010. A Pilot Trial of Adjunctive Prednisolone and Mycobacterium w Immunotherapy in Tuberculous Pericarditis (IMPI). Available at: http://clinicaltrials.gov/ct2/show/NCT00810849. Accessed April 28, 2010. [Google Scholar]
  19. McAllister WA, Thompson PJ, Al-Habet SM, Rogers HJ, , 1983. Rifampicin reduces effectiveness and bioavailability of prednisolone. Br Med J (Clin Res Ed) 286: 923925.[Crossref] [Google Scholar]
  20. Strang JI, , 1994. Rapid resolution of tuberculous pericardial effusions with high dose prednisone and anti-tuberculous drugs. J Infect 28: 251254.[Crossref] [Google Scholar]
  21. World Health Organization, 2007. WHO Case Definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Classification of HIV-Related Disease in Adults and Children. Geneva: World Health Organization. [Google Scholar]
  22. Abdool Karim SS, Naidoo K, Grobler A, Padayatchi N, Baxter C, Gray A, Gengiah T, Nair G, Bamber S, Singh A, Khan M, Pienaar J, El-Sadr W, Friedland G, Abdool Karim Q, , 2010. Timing of initiation of antiretroviral drugs during tuberculosis therapy. N Engl J Med 362: 697706.[Crossref] [Google Scholar]
  23. Velasco M, Castilla V, Sanz J, Gaspar G, Condes E, Barros C, Cervero M, Torres R, Guijarro C, , 2009. Effect of simultaneous use of highly active antiretroviral therapy on survival of HIV patients with tuberculosis. J Acquir Immune Defic Syndr 50: 148152.[Crossref] [Google Scholar]
  24. Meintjes G, Rangaka MX, Maartens G, Rebe K, Morroni C, Pepper DJ, Wilkinson KA, Wilkinson RJ, , 2009. Novel relationship between tuberculosis immune reconstitution inflammatory syndrome and antitubercular drug resistance. Clin Infect Dis 48: 667676.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2010.10-0271
Loading
/content/journals/10.4269/ajtmh.2010.10-0271
Loading

Data & Media loading...

Supplementary Video 2. Video for the patient post-pericardiocentesis showing improved right ventricular filling.

Supplementary Video 1. Video for the patient showing large pericardial effusion and right ventricular collapse characteristic of cardiac

  • Received : 13 May 2010
  • Accepted : 16 Jun 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error