rifampin and Pericarditis--Tuberculous

Tuberculosis-associated pericardial disorders are an excessively rare manifestation of extrapulmonary tuberculosis. The patients may present with constrictive pericarditis or pericardial fluid accumulation leading to cardiac tamponade. This paper reports a case of tuberculosis-associated pericardial effusion with dense fibrinous material not causing tamponade in a foreigner presenting with nonspecific symptoms. It also provides a discussion about the diagnostic and therapeutic methods as well as interesting echocardiographic images of the patient.

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Antitubercular Agents; Diagnosis, Differential; Echocardiography; Ethambutol; Female; Humans; Isoniazid; Middle Aged; Pericardial Effusion; Pericarditis, Tuberculous; Rifampin; Streptomycin

Pericardial effusion is common disease and difficult to diagnose. Tuberculosis accounts for up to 4% of acute pericarditis and 7% of cardiac tamponade cases. Quick treatment can be lifesaving but requires accurate diagnosis. We report a case of a 65-year-old man who presented with a 3-week history of fever with chills, non-productive cough and dyspnea. The case was diagnosed by positivity of acid-fast staining, culture and polymerase chain reaction (PCR) of the aspirated pericardial fluid and treated promptly with antituberculosis drugs. The patient showed complete recovery.

Topics: Aged; Antitubercular Agents; Ethambutol; Humans; Isoniazid; Male; Pericarditis, Tuberculous; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculin Test

Topics: Adult; Antitubercular Agents; Disease Progression; Dyspnea; Ethambutol; Female; Humans; Isoniazid; Mediastinum; Pericarditis, Tuberculous; Pyrazinamide; Radiography; Rifampin; Tuberculosis, Lymph Node

We describe a case in which the rapid diagnosis of tuberculous pericarditis was made using the Mycobacterium tuberculosis (MTB)-specific enzyme-linked immunospot (ELISPOT) assay on pericardial effusion mononuclear cells (PEMCs). The analysis of MTB-specific T-cells in PEMCs by ELISPOT may be useful for rapid decision-making in anti-tuberculous treatment.

Topics: Aged, 80 and over; Antitubercular Agents; Drug Combinations; Enzyme-Linked Immunospot Assay; Humans; Isoniazid; Male; Mycobacterium tuberculosis; Pericardial Effusion; Pericarditis, Tuberculous; Pyrazinamide; Rifampin; T-Lymphocytes

Topics: Antitubercular Agents; Drug Therapy, Combination; Female; Fever; Glucocorticoids; Humans; Immunocompromised Host; Isoniazid; Liver Cirrhosis, Biliary; Liver Transplantation; Middle Aged; Mycobacterium tuberculosis; Pericardiocentesis; Pericarditis, Tuberculous; Prednisolone; Pyrazinamide; Rifampin; Treatment Outcome

A 36-month-old girl was treated for pulmonary tuberculosis (Mycobacterium tuberculosis) with isoniazid, rifampin and pyrazinamide. Four weeks after starting chemotherapy, she developed high fever and clinical signs of acute pericardial tamponade. Pericardial effusion was shown by echocardiography and subsequently removed by pericardiocentesis. M. tuberculosis was demonstrated in the pericardial fluid by microscopy, polymerase chain reaction and specific culture. After pericardial drainage, the actual therapy was extended to include streptomycin and prednisone. Follow-up examinations demonstrated complete recovery without signs of constrictive pericarditis.. infants treated for tuberculosis should be followed closely in order to monitor not only side-effects of antituberculous drugs but also to detect early extrapulmonary spread that may occur even with adequate chemotherapy. Rapid intervention and treatment adjustment in infants with tuberculous pericarditis may prevent pericardial constriction and may lead to full recovery.

Topics: Antitubercular Agents; Child, Preschool; Drug Therapy, Combination; Echocardiography; Female; Humans; Isoniazid; Pericardial Effusion; Pericarditis, Tuberculous; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Pulmonary

Ten patients with tuberculous pericardial effusion, treated initially with adjunctive prednisone 120 mg daily, improved dramatically within a week. There were no complications. Such rapid resolution suggests that the duration of prednisone treatment for this condition could be shortened, which may be important in HIV seropositive patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antitubercular Agents; Female; HIV Seronegativity; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Pericardial Effusion; Pericarditis, Tuberculous; Prednisone; Rifampin

A fifty-four-year-old woman from a high socioeconomic class developed acute isolated tuberculous pericarditis, three years after her sister had recovered from such disease. She was treated successfully by a triple drug regimen including isoniazid, rifampin, and ethambutol.

Topics: Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Middle Aged; Pericarditis, Tuberculous; Rifampin

A 6-year-old boy with active tuberculosis developed a pericarditis 9 weeks after starting adequate chemotherapy. Although no Mycobacterium tuberculosis was isolated from the pericardial fluid we assume, for several reasons, that the pericarditis was caused by tuberculosis. Consequently, it is important to be aware of possible serious complications even during treatment with adequate antituberculous drugs.

Topics: Child; Ethambutol; Humans; Isoniazid; Male; Pericarditis, Tuberculous; Prednisone; Rifampin; Streptomycin; Tuberculosis, Cardiovascular; Tuberculosis, Pulmonary

Topics: Adult; Drug Interactions; Humans; Male; Pericarditis, Tuberculous; Prednisolone; Rifampin; Tuberculosis, Cardiovascular