Pericarditis tuberculosa: experiencia de 10 años / Tuberculous pericarditis: ten years experience

We review the clinical files of patients who entered the Regional General Hospital No. 20 IMSS in the City of Tijuana Mexico between May 1994 and May 2004 with diagnosis of primary acute pericardial disease. Patients diagnosed as having active tuberculous pericardial effusion were eligible for the study. Twenty-one were included in the study (14 men and 7 women). The aged ranged from 16 to 48 years (mean 36 years). The diagnosis was made by the following studies: identification of tubercle bacilli in the pericardial fluid or tissue (n = 4), identification of caseating granulomas in the pericardium or elsewhere (n = 2), positive culture for Mycobacterium tuberculosis in pericardial fluid (n = 8), in pleural fluid (n = 1), sputum culture (n = 3), gastric aspirate samples (n = 1), lymph node biopsy (n = 1), and pericardial effusion without obvious cause, responding to antituberculous therapy (n = 5). The clinical, laboratory, electrocardiography, radiographic, and echocardiography features were analyzed. We review in each patient follow-up, pericardial fluid cytology, and pericardial biopsy, if available. All patients had pericardial effusion; nine (42.8%) patients had cardiac tamponade. Pericardiocentesis was performed in 16 patients, [quot ]therapeutic[quot ] pericardiocentesis was performed in 43.7%, and [quot ]diagnostic[quot ] pericardiocentesis was performed in 56.2% all cases. Constrictive pericarditis developed in two patients, all required partial pericardiectomy. All patients received triple antituberculous chemotherapy. No patient died.

Pericarditis por coccidioidomicosis. Informe de un caso / Pericarditis due to coccidioidiomycosis. Report on one case

Se trata de un hombre de 33 años, que presentó coccidioidomicosis diseminada con pericarditis, manifestando datos de insuficiencia cardiaca. Desarrolló derrame pericárdico que progresó hacia pericarditis constrictiva. Se realizó pericardiectomía y resección de pericardio. El examen microscópico identificó numerosas esférulas de Coccidioides immitis. El paciente falleció en el postoperatorio inmediato. Este es el segundo caso de coccidioidomicosis diseminada con pericarditis, reportado en la literatura médica mexicana.