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Tuberculous Pericardial Effusions in Children

Ndidi J Obihara1, Elisabetta Walters2, John Lawrenson3

  • 1Faculty of Medical Sciences, Radboud University, Nijmegen, the Netherlands.

Journal of the Pediatric Infectious Diseases Society
|November 3, 2017
PubMed

Insights

Tuberculous pericardial effusion in children is uncommon, with high rates of HIV and confirmed tuberculosis. While chest radiography is less sensitive than sonography, it identifies large effusions, and outcomes are typically good, often impacted by other health conditions.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Limited current data exists on childhood tuberculous pericardial effusion.
  • Tuberculosis affecting the pericardium in pediatric populations requires further investigation.

Purpose of the Study:

  • To retrospectively review cases of tuberculous pericardial effusion in children.
  • To analyze the prevalence of comorbidities and diagnostic imaging findings.
  • To assess treatment outcomes and identify factors influencing them.

Main Methods:

  • Retrospective case review of 30 children diagnosed with tuberculous pericardial effusion.
  • Analysis of patient demographics, clinical presentation, diagnostic methods (chest radiography, sonography), and treatment regimens.
  • Evaluation of outcomes, including resolution, complications, and mortality.

Main Results:

  • High prevalence of human immunodeficiency virus (HIV) coinfection and culture-confirmed tuberculosis was observed.
  • Chest radiography demonstrated lower diagnostic sensitivity compared to sonography.
  • Sonography proved effective in diagnosing effusions, while chest radiography successfully identified large and complicated effusions.
  • Overall outcomes were favorable, with residual complications primarily linked to comorbid conditions.

Conclusions:

  • Tuberculous pericardial effusion in children, though rare, is associated with significant comorbidities like HIV.
  • A combination of diagnostic imaging modalities, including sonography and chest radiography, is valuable for detection and characterization.
  • Prompt diagnosis and management, alongside addressing comorbidities, are crucial for favorable outcomes in pediatric tuberculous pericardial effusion.

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