Tuberculous pericarditis in children

Epidemiologia da tuberculose infantil na cidade do Rio de Janeiro, RJ

“…A média do coeficiente de incidência de tuberculose em menores de 15 anos no período de 1989 a 1993, encontrada no estudo, 1 é semelhante à do Município de São Paulo, em 1984, com 21,4/100.000 habitantes e muito inferior à de Western Cape, Áfri-ca, onde o coeficiente de incidência em menores de 14 anos em 1991 foi de 575/100.000 habitantes, 2,3 demonstrando possível correlação com desenvolvimento socioeconômico das cidades.…”

Tuberculous pericarditis in an infant evolving during triple chemotherapy

“…In industrialised countries, the most common complication is tuberculous meningitis whereas tuberculous pericarditis is rare, affecting less than 1% of children with pulmonary tuberculosis [8]. In developing countries, tuberculosis is still a major health problem and tuberculous pericarditis may be a leading cause of pericardial effusions in adults and children [11]. More recently, tuberculous pericarditis has gained additional importance in immuno-compromised patients, particularly those with the acquired immunodeficiency syndrome [4].…”

“…Tuberculous pericarditis, although well-described in adults, represents a rare manifestation of childhood tuberculosis in countries with a low prevalence of the disease [11]. Pericarditis may be the only clinical manifestation of tuberculous disease and few patients with pericarditis have active pulmonary tuberculosis.…”

“…Children and immuno-compromised patients are more susceptible to haematogenous dissemination of Mycobacterium tuberculosis; they are, therefore, at risk to develop tuberculous pericarditis [17]. It has been suggested that tuberculous pericarditis may develop during adequate chemotherapy of pulmonary tuberculosis, although it may be difficult to prove the tuberculous aetiology of pericardial effusions in children [10,11]. Early diagnosis, however, and adequate treatment of pericardial tuberculosis are crucial in order to reduce acute mortality and to prevent serious sequelae such as constrictive pericarditis.…”

Diagnosis of tuberculous aetiology in pericardial effusions

“…2 In another study of 44 children with TPE, 90% had tamponade. 35 In a recent report from the USA both patients reported had tamponade 36 and in an earlier report 6/11 deaths were due to tamponade. 7 Since tamponade may in part be due to late presentation ,the incidence is likely to be higher in Afro-Asian countries.…”