Frequency of tuberculous pericarditis in patients with the diagnosis of pericarditis

During the past decades the prevalence of tuberculosis (TB) has declined and its prognosis has changed dramatically due to chemotherapy; however, cases of tuberculous pericarditis are still reported worldwide. The study population included 19 men and 11women aged 12-76 years admitted to the hospital for acute pericardial disease. The diagnosis of tuberculous pericarditis was verified based on the adenosin deaminase activity (ADA), culture on Lowenstein-Jensen media, Ziehl Neelsen staining, biopsy of pericardial tissue and evaluation of tuberculin test. Of 30 patients, 13 (43.3%) had tuberculous pericarditis. All of whom had clinical TB manifestations. The culture of pericardial fluid in 6 patients (46%), staining in 3 (23%), and the culture of pericardial tissue in 6 patients (46%) were positive. The caseating granuloma w identified in 46% of cases. Ten case (77%) had positive PPD reaction. All tuberculous pericarditis patients had ADA level of >45U/l. Results have revealed that measurement of ADA level may prove a good screening test for early diagnosis of tuberculous pericarditis.