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Tuberculous pericardial effusion: features, tamponade, and computed tomography.
George Cherian1, Babu Uthaman, Abdulatif Salama
1Department of Medicine, Ministry of Health, Kuwait. gcherian@vsnl.net
Angiology
|July 20, 2004
Summary
Tuberculous pericardial effusion often presents with fever, dyspnea, and tamponade. Mediastinal lymph node enlargement on CT scans, alongside a positive skin test, aids in diagnosing this condition.
Area of Science:
- Cardiology
- Infectious Diseases
- Radiology
Background:
- Tuberculous pericardial effusion diagnosis can be challenging, with tamponade being a frequent complication.
- The role of mediastinal lymph node involvement in tuberculous pericardial effusion requires further study.
Purpose of the Study:
- To investigate the clinical features of tuberculous pericardial effusion, focusing on tamponade and mediastinal adenopathy.
- To evaluate the utility of chest computed tomography (CT) in identifying mediastinal lymph node enlargement in tuberculous pericardial effusion.
Main Methods:
- A prospective cohort study included patients with large pericardial effusions undergoing pericardiocentesis and chest CT.
- Patients with tuberculosis received specific therapy, while viral/idiopathic effusion cases served as controls for CT analysis.
Main Results:
- Tuberculosis patients frequently exhibited fever, dyspnea, and tamponade. All 26 tuberculosis patients had enlarged mediastinal lymph nodes (>10 mm) on CT, which regressed with treatment.
- Mediastinal lymph node enlargement was specific to tuberculous effusion and absent in viral/idiopathic cases. A granuloma was found in 22 of 24 biopsy specimens.
Conclusions:
- Mediastinal lymph node enlargement on chest CT, combined with a positive tuberculin skin test, can aid in diagnosing tuberculous pericardial effusion.
- Prompt diagnosis and specific therapy for tuberculous pericardial effusion lead to a good prognosis.