Chapter 22 : Cardiovascular Tuberculosis

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Cardiovascular tuberculosis is an uncommon extrapulmonary manifestation of mycobacterial disease. With the advent of AIDS, which has increased the incidence of mycobacterial disease, particularly of the extrapulmonary type, one can expect an increase in cardiovascular tuberculosis. Pericardial tuberculosis is the disease present in the greatest percentage of patients with cardiovascular tuberculosis. Tuberculosis of the aorta and myocardium are reported but extremely unusual forms of cardiovascular tuberculosis. Pericardial tuberculosis is rare, occurring in less than 1% of cases of tuberculosis, and may be life threatening. In a study in sub-Saharan Africa, researchers found that the major independent predictors of death were an additional proven nontuberculosis final diagnosis, presence of clinical signs of human immunodeficiency virus (HIV) infection, coexistent pulmonary tuberculosis, and older age. Pericardial biopsy has also been advocated in the diagnosis of pericarditis. Between 1950 and 1970, many investigators thought that examination of the entire pericardium at pericardiectomy or autopsy was required to definitively diagnose tuberculosis. The prednisolone group had a significantly more rapid resolution of hepatomegaly and elevated jugular venous pressure and more rapid improvement in physical activity. The authors conclude that antituberculosis medication with prednisolone resulted in a significant decrease in constrictive pericarditis, particularly in patients with a shaggy tuberculous pericardial effusion compared with those who did not receive prednisolone.

Citation: Crocco J. 2011. Cardiovascular Tuberculosis, p 335-349. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch22

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