Tuberculous Pericarditis

Pericarditis is a rare manifestation of tuberculous disease. The appropriate diagnostic workup and optimal therapeutic management are not well defined. The etiology of constrictive pericarditis is often obscure, but is frequently associated with viral infection and tuberculosis, especially in the developing countries. The disease has decreased in industrialized countries but continues to be important in immunosuppressed patients including those with HIV/AIDS. The literature suggests that the optimal management includes an open pericardial window with pericardial biopsy, both for diagnosis and to prevent fluid reaccumulation. Corticosteroids may offer some benefit. The objectives of this review are to review the pathogenesis and clinical manifestations of tuberculous pericarditis, highlight the diagnostic difficulties, and discuss optimal case management including surgery, and the potential role of corticosteroids.