Tuberculous pericarditis: ten year experience with a prospective protocol for diagnosis and treatment

J Am Coll Cardiol. 1988 Apr;11(4):724-8. doi: 10.1016/0735-1097(88)90203-3.


Thirteen patients with tuberculous pericarditis (12 men and 1 woman aged 13 to 70 years [mean 41]) were identified in a group of 294 patients consecutively admitted for primary acute pericardial disease. The diagnosis was made by the following studies: sputum culture (n = 4), culture of pericardial fluid obtained by pericardiocentesis (n = 3), histologic study and culture of pericardial biopsy (n = 3), lymph node biopsy (n = 2) and pleural biopsy (n = 1). Clinical presentation was remarkably variable: four patients had an acute, apparently self-limited course, one had relapsing tamponade, four had tamponade effectively treated with pericardiocentesis and four had toxic symptoms with persistent fever. The interval from hospital admission to diagnosis ranged from 1 to 14 weeks (mean 5.2). Constrictive pericarditis developed in six patients and effusive-constrictive pericarditis in one; all seven required pericardiectomy 2 to 3.5 months after admission. No patient died. It is concluded that 1) tuberculous pericarditis has a variable clinical presentation and therefore it should be considered in the evaluation of all instances of pericarditis without a rapidly self-limited course; 2) the diagnosis should be based only on objective data obtained with a systematic study protocol; 3) early definitive diagnosis is still difficult to achieve; and 4) development of subacute constrictive pericarditis requiring pericardiectomy is common.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nontuberculous Mycobacteria / isolation & purification
  • Pericarditis, Tuberculous / diagnosis*
  • Pericarditis, Tuberculous / drug therapy
  • Pericardium / microbiology
  • Prospective Studies
  • Sputum / microbiology
  • Tuberculosis, Cardiovascular / diagnosis*


  • Antitubercular Agents