How is tuberculous pericarditis diagnosed in patients with pericardial effusion?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

A definite diagnosis of tuberculous pericarditis is based on the demonstration of tubercle bacilli in pericardial fluid or on a histologic section of the pericardium.

Probable tuberculous pericarditis is based on the proof of tuberculosis elsewhere in a patient with otherwise unexplained pericarditis, a lymphocytic pericardial exudate with elevated adenosine deaminase or gamma interferon (IFN) levels, and/or appropriate response to a trial of antituberculosis chemotherapy.

Elevated carcinoembryonic antigen (CEA) levels in pericardial fluid have a high specificity for malignant effusion.

Perform pericardial biopsy, especially if malignant pericardial effusion is suspected. [16] This can be more diagnostic when combined with pericardioscopy. [17]


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