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Case Reports
. 2010 Dec;83(6):1311-4.
doi: 10.4269/ajtmh.2010.10-0271.

Tuberculosis pericarditis with cardiac tamponade: management in the resource-limited setting

Tom Heller  1 , Richard J Lessells, Claudia Wallrauch, Enrico Brunetti
Affiliations
Case Reports

Tuberculosis pericarditis with cardiac tamponade: management in the resource-limited setting

Tom Heller et al. Am J Trop Med Hyg. 2010 Dec.

Abstract

We report a case of human immunodeficiency virus-associated pericardial tuberculosis complicated by cardiac tamponade. Emergency management and subsequent therapeutic interventions are described and then discussed with particular focus on resource-limited settings. The paucity of evidence to support clinical decisions is emphasized and the need for well designed diagnostic and therapeutic studies is highlighted.

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Figures

Figure 1.
Figure 1.
Ultrasound at presentation for the patient, showing large pericardial effusion and right ventricular collapse.
Figure 2.
Figure 2.
Ultrasound post-pericardiocentesis for the patient, showing persistent large effusion but improved right ventricular filling.
Figure 3.
Figure 3.
Ultrasound on day 3 for the patient, showing reduction in pericardial effusion.
Figure 4.
Figure 4.
Sites for pericardiocentesis. A, Standard sub-xiphoidal approach. B, Intercostal approach used with ultrasound guidance in this case.
See this image and copyright information in PMC

References

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    1. Wallrauch C, Heller T, Lessells R, Kekana M, Barnighausen T, Newell ML. High uptake of HIV testing for tuberculosis patients in an integrated primary health care HIV/TB programme in rural KwaZulu-Natal. S Afr Med J. 2010;100:146–147. - PubMed
    1. Mayosi BM, Wiysonge CS, Ntsekhe M, Volmink JA, Gumedze F, Maartens G, Aje A, Thomas BM, Thomas KM, Awotedu AA, Thembela B, Mntla P, Maritz F, Blackett KN, Nkouonlack DC, Burch VC, Rebe K, Parish A, Sliwa K, Vezi BZ, Alam N, Brown BG, Gould T, Visser T, Shey MS, Magula NP, Commerford PJ. Clinical characteristics and initial management of patients with tuberculous pericarditis in the HIV era: the Investigation of the Management of Pericarditis in Africa (IMPI Africa) Registry. BMC Infect Dis. 2006;6:2. - PMC - PubMed
    1. World Health Organization . Improving the Diagnosis and Treatment of Smear-Negative Pulmonary and Extrapulmonary Tuberculosis among Adults and Adolescents. Recommendations for HIV-Prevalent and Resource-Constrained Settings. Geneva: World Health Organization; 2007.

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