Childhood Tuberculous Pericarditis

¹ Clinical Professor of Medicine
² Lecturer in Pediatrics, Hospital for Sick Children, London, England
³ Division of Cardiology, Makerere Medical School and Mulago Hospital, Kampala, Uganda
⁴ Lecturer, Department of Surgery

Five East African children with tuberculous pericarditis were seen over a two-year period. Three patients, in the effusive stage at the time of presentation, were treated with steroids in addition to antituberculosis drugs. Apparently pericardial constriction has been avoided in the first patient; the second patient was evidently cured of the tuberculous pericarditis although she died of an unrelated disease. In the third patient pericardiectomy was unavoidable. A fifth patient with calcific constriction is the youngest patient ever reported. In East African experience, tuberculous pericarditis has to be differentiated from endomyocardial fibrosis. Differential diagnosis is not really necessary once the Mycobacterium tuberculosis organism is demonstrable in the pericardial exudate or the granulation tissue. A difficulty in developing countries in therapy is the great problem of continuous and long-term medication.