Tuberculous pericarditis

Abstract

The true incidence of tuberculous pericarditis is not accurately known. Most available studies were performed before the introduction of modern chemotherapy, and some series include cases classified as tuberculous without proof but on the basis of indirect evidence. In Wood’s series (1), the incidence of pericardial involvement in patients who died of tuberculosis was 7.8%. In his comprehensive review of the disease, Schepers (2) remarked that 7–10% of pericarditis were tuberculous. In addition, there are wide geographic and racial variations (3, 4), and an increasing incidence has been recently reported in some populations (5, 6). The incidence of tuberculous pericarditis in Spain is not known, as recent reports are based on isolated observations of small numbers of patients (7, 8). However, it is likely that the prevalence has remained constant for many years, particularly if pericarditis behaves like other extrapulmonary manifestations of tuberculosis, the incidence of which has not changed over the last several years. Tuberculous pericarditis complicating acquired immunodeficiency syndrome has been recently reported (9–11) raising the possibility that some other cases have gone undiagnosed. Between January 1977 and June 1986 we had seen 13 patients with tuberculous pericarditis (12), among 294 consecutive patients with primary acute pericardial disease, that is, acute pericardial disease without evidence of its etiology at the time of admission.