Jove
Visualize
Contact Us

Related Experiment Videos

Diagnosing tuberculous pericarditis.

H Reuter1, L Burgess, W van Vuuren

  • 1Cardiology Unit/TREAD Research, Tygerberg Hospital and Stellenbosch University, Parow, South Africa.

QJM : Monthly Journal of the Association of Physicians
|November 24, 2006
PubMed
Summary

Diagnosing tuberculous pericarditis is challenging. New models using clinical features, pericardial fluid adenosine deaminase (ADA), and white blood cell (WBC) counts improve diagnostic accuracy.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The incidence and outcomes of high-risk acute coronary syndromes in Western Cape Province, South Africa: A prospective cohort study.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde·2023
Same author

Bleeding and thrombosis outcomes in hospitalised COVID-19 patients on low-molecular-weight heparin and antiplatelet therapy.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde·2022
Same author

Safety and efficacy of inclisiran in South African patients at high cardiovascular risk: A subanalysis of the ORION phase III clinical trials.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde·2022
Same author

Ivermectin exposures reported to the Poisons Information Helpline in South Africa during the COVID-19 pandemic.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde·2022
Same author

Reaching Ambulatory Older Adults with Educational Tools: Comparative Efficacy and Cost of Varied Outreach Modalities in Primary Care.

Journal of general internal medicine·2022
Same author

Echocardiographic features of infective endocarditis in South Africa: A prospective cohort study.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde·2022
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Diagnostic Medicine

Background:

  • Tuberculous pericarditis diagnosis is difficult due to low tubercle bacillus isolation rates from pericardial fluid.
  • Improving diagnostic efficiency for tuberculous pericarditis is crucial for timely treatment.

Purpose of the Study:

  • To enhance the diagnostic efficiency of tuberculous pericarditis using existing tests.
  • To develop and validate predictive models for tuberculous pericarditis diagnosis.

Main Methods:

  • Prospective observational study of 233 patients with pericardial effusions.
  • Comprehensive diagnostic work-up including clinical examination, pericardial fluid analysis (biochemistry, microbiology, cytology, WBC count, IFN-gamma, ADA, PCR), HIV status, and sputum analysis.
  • Development of a prediction model using classification and regression tree analysis, with optimization via ROC curves.

Main Results:

  • Clinical predictors include fever, night sweats, weight loss, elevated serum globulin, and specific peripheral blood leukocyte counts.
  • Pericardial fluid interferon-gamma (IFN-gamma) demonstrated high sensitivity (92%) and specificity (100%).
  • A diagnostic model incorporating pericardial adenosine deaminase (ADA), lymphocyte/neutrophil ratio, peripheral leukocyte count, and HIV status achieved 96% sensitivity and 97% specificity.
  • Substituting pericardial IFN-gamma for ADA in the model yielded 98% sensitivity and 100% specificity.

Conclusions:

  • Clinical and laboratory findings significantly aid in diagnosing tuberculous pericarditis.
  • Pericardial fluid IFN-gamma is the most effective diagnostic marker when available.
  • A proposed prediction model using pericardial ADA and differential WBC counts offers a viable alternative for diagnosis.

Related Experiment Videos