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At least 19 recordsLinked to original sources
PubMed1979

Tuberculous pericarditis.

Tuberculous pericarditis is a rare but dangerous disease with a mortality of 20% to 40%. Early diagnosis and institution of appropriate therapy are critical, and open pericardial biopsy appears to be the most reliable diagnostic tool. Corticosteroids, in conjunction with antituberculous medication, are effective in suppressing the early granulomatous inflammatory response. Pericardiectomy should be considered early when the response to a medical regimen is delayed or inadequate.

Adrenal Cortex Hormones↗
PubMed1978

Tuberculous pericarditis in Birmingham.

Forty-one patients with acute tuberculous pericarditis were studied retrospectively. Anti-tuberculosis chemotherapy alone was effective in thirty. Five patients died, two from unrelated causes, two due to delayed diagnosis, and one after pericardiectomy. Constrictive pericarditis developed in seven patients, six of whom had successful pericardiectomy. Corticosteroids could not be shown to have reduced the risk of developing constriction. When constriction occurred it did so within the first six months of illness in all cases in contrast to a separate series of 15 patients who presented with constrictive pericarditis. These had had no previous history of tuberculosis, and in 10 cases where pericardiectomy was done, no histological evidence of tuberculosis was found. They were European with an average age of 49 years whereas in the group with acute tuberculous pericarditis 33 were Asian and the average age was 36 years.

Acute Disease↗
PubMed1976

Total electrical alternans in a patient with tuberculous pericarditis.

Total electrical alternans is an uncommon electrocardiographic abnormality in which alternation in the direction and/or amplitude of all the components (P, QRS and T) of the tracing is present. The phenomenon is seen only in association with occasional cases of pericaditis with large effusion's. Knowledge of this fact may help in the often difficult differentiation between a pericardial effusion and cardiomyopathy. An illustrative case report is presented, with a résumé of the mechanisms postulated to explain total electrical alternans.

Adult↗
PubMed1979

Tuberculous pericarditis. A review of 100 cases.

A retrospective survey of 100 Black patients with presumed tuberculous paricarditis showed that 82 presented with pericardial effusion while 18 had constrictive pericarditis. The mortality rate was 17%. Of the 82 patients with pericardial effusion, 15 developed 'constricting pericarditis' within 4 months; 12 required pericardiectomy. Sixteen patients died of cardiac tamponade; the effusion had been confirmed by a radio-isotope heart pool scan but had not been aspirated. This emphasizes the need for early and repeated pericardial aspiration. The fate of 38 rural patients with pericardial effusion was not known. Of the 18 patients with constrictive pericarditis, 7 underwent pericardiectomy, while 3 refused operation.

Adolescent↗
PubMed1978

A clinicopathological study on pericardial heart disease in the aged.

A total of 87 cases of pericardial heart disease (73 of pericarditis and 14 of hemopericardium) among 870 consecutive autopsies of aged patients was studied. Fibrinofibrouspericarditis was found in 80.8% of pericarditis, neoplastic in 13.7% and purulent in 5.5%. Representative cases of each type of pericarditis were illustrated. Among fibrinofibrous pericarditis, idiopathic was the most common and the other causes included irradiation, myocardial infarction, renal failure, rheumatoid arthritis and hypothyroidism. Frequent association of congestive heart failure or anasarca with mild to moderate fibrinofibrous pericarditis was noted. Clinical and morphologic evidences of pulmonary tuberculosis were present in nearly one third of cases with fibrinofibrious pericarditis, but actual incidence of tuberculous pericarditis could not be determined. Incidence of clinical signs and symptoms of acute pericarditis was evaluated with the stress on the relatively high incidence of supraventricular tachyarrhythmias, especially in cases with histological evidence of sinus node involvement in aged cases.

Aged↗
PubMed1977

Early recognition of cardiac tamponade.

Nine patients with cardiac tamponade were seen in an 11-month period. Analysis of the clinical and laboratory data indicated that pulsus paradoxus was the most useful physical sign and echocardiography the most useful investigative technique. Three of nine patients died but in only one was the late recognition of tamponade a possible factor in the outcome. Pericardial fenestrations were required in four patients. Viral pericarditis accounted for the tamponade in three cases. There were two cases each of uremia and malignant disease and one case of tuberculous pericarditis. One other case followed pericardiectomy. In five patients tamponade was the initial manifestation of illness.

Adult↗
PubMedDate not supplied

Infections or neoplasm as causes of prolonged fever in cancer patients.

Thirty-six consecutive patients with cancer who met the classical criteria for fever of unexplained origin (FUO) were identified. A total of 18 patients had infections including all 12 with leukemia, four of 12 with Hodgkin's disease, and two with solid tumors. Fungal infections were found in nine: histoplasmosis, three; candidiasis, three; and aspergillosis, systemic sporotrichosis, or cryptococcal meningitis, one each. Six patients had unresolved pyogenic infections and one had tuberculous pericarditis. Two others had viral etiologies. Granulocytopenia was significantly more common in the FUO patients with documented infections. Clinical or laboratory abnormalities suggesting involvement of a specific organ or organ system provided important clues indicating infections. Morphological examination of biopsy specimens, with cultures, was the best method for diagnosis. In 18 patients, 12 with lymphomas and 6 with solid tumors, only the neoplasm appeared responsible for the fever. In these patients there was a paucity of abnormalities indicating organ system involvement with infection. Regardless, physicians' diagnostic efforts should not be deterred in such patients. Repeated thorough evaluations for infection are warranted.

Adolescent↗
PubMed1979

Pericarditis: differential diagnostic considerations.

A retrospective analysis of 133 patients was performed to define the factors identifying those individuals at risk for the more serious causes of pericardial disease. In 90% of the cases, the initial assessment from data obtained without pericardiocentesis or pericardiectomy proved correct. Underlying tuberculous or maligant pericarditis were the most common sources of error on initial assessment. Hemodynamic compromise exclusive of anticoagulants, roentgenographic cardiomegaly, pleural effusion, low voltage on ECG, and large pericardial effusion by echocardiography were more common (P less than .05) in tuberculous pericarditis than in acute idiopathic pericarditis. We discuss similar risk factors in patients with chronic idiopathic, rheumatologic, and uremic pericarditis. Anterior pericardiectomy is favored as the diagnostic procedure of choice in patients at risk for the more serious causes of pericarditis because of greater safety, diagnostic sensitivity, and potential therapeutic benefit.

Adult↗
PubMed1977

Pericarditis purulenta in children.

The case history of seven children aged 1 5/12 to 5 9/12 years with non tuberculous bacterial pericarditis, observed in the last 8 years at the University children's hospitals of Basle, Berne and Zurich is reported. The history showed febrile illness of 3--14 days duration, which led to an admission diagnosis of pneumonia, angina or pseudocroup. From the signs of heart failure and cardiomegaly on chest X-ray the differential diagnosis of myocardial disease or pericardial effusion was made. The ECG-changes were uncharacteristic, and a friction rub and pulsus paradoxus was encountered once only. The effusion diagnosis should preferably be substantiated by a non-invasive method (scintigram, echocardiogram) as diagnostic pericardiocentesis does often not allow to aspirate the thick pus through the needle. Diagnostic and therapeutic surgical pericardiotomy with consecutive drainage is therefore mandatory. Halothane should be avoided as an anesthetic for this procedure of hemodynamic reasons. With surgery and antibiotics the recovery rate in our series was 100%, and no pericardial constriction was observed on follow-up 1 to 8 years later.

Acute Disease↗
PubMed1976

[Richettsial pericarditis and pleurisy].

The authors report two cases of rickettsial disease due to R. Conori with mainly pericarditis in one case, sero-fibrinous pleurisy in the other. They then recall a few general data concerning this rickettsial disease and the very restricted place that it occupies in the etiology of pericarditis and, even more so, in the case of pleurisy. The conditons of diagnosis, which are mainly serological, are discussed, in particular with regard to pericarditis and tuberculous pleurisy.

Acute Disease↗
PubMedDate not supplied

[Extrapulmonary tuberculosis in Africans (author's transl)].

Extra pulmonary tuberculosis are frequent in Africa and have a special severity due to delayed diagnosis and multifocal forms. Various punctures and biopsies may be necessary to demonstate the tuberculous infection. Even with modern treatment it too often implies important risks of severe sequelae.

Adult↗
PubMed1975

Extrapulmonary tuberculosis in Oklahoma, 1965 to 1973.

Three hundred seventy cases of extrapulmonary tuberculosis were reported to the Oklahoma State Department of Health between January 1, 1965 and December 31, 1973. The annual number of cases reported showed no tendency to decrease with time. A greater proportion of cases reported in recent years had bacteriologic confirmation. When compared to the distribution of all newly diagnosed cases of tuberculosis in the population, a greater proportion of newly diagnosed cases of extrapulmonary tuberculosis occurred in nonwhites. This was especially true to tuberculous meningitis, tuberculous lymphadenitis, and miliary tuberculosis. Possible reasons for the failure of the number of newly reported cases of extrapulmonary tuberculosis to decrease in recent years are presented.

Adolescent↗
PubMed1979

Low-pressure cardiac tamponade.

An elderly man developed cardiac tamponade from a tuberculous pericardial effusion but without such typical manifestations as pulsus paradoxus and jugular-vein distension. This case illustrates the difficulties in clinical recognition of low-pressure cardiac tamponade, which can develop in the presence of dehydration and hypovolemia. The hemodynamic factors that account for this phenomenon are discussed.

Aged↗