Sá Isabel, Môço Rui, Cabral Sofia, Reis António Hipólito, Pereira Luís Sousa, Torres Severo, Gomes J Lopes
Serviço de Cardiologia, Hospital Geral de Santo António, Porto, Portugal.
Rev Port Cardiol. 2006 Nov;25(11):1029-38.
Pericardial inflammation secondary to Mycobacterium tuberculosis infection is a rare condition, but its incidence is increasing in parallel with human immunodeficiency virus infection. Recrudescence of various types of tuberculosis should alert the clinician to the possibility of tuberculous pericarditis. The authors present the case of a 27-year-old white male, seropositive for the human immunodeficiency virus, presenting with large volume pericardial effusion and unusual echocardiographic features, global heart failure and clinical suspicion of tuberculosis. After anti-tuberculous chemotherapy and systemic corticosteroids there was some clinical improvement but evolution to constriction. The patient underwent pericardiectomy with good results. The authors present a literature review on constrictive tuberculous pericarditis in human immunodeficiency virus seropositive and seronegative patients, discussing the role of corticosteroids and the contribution of different diagnostic tools.
继发于结核分枝杆菌感染的心包炎是一种罕见疾病，但其发病率随着人类免疫缺陷病毒感染的增加而上升。各类结核病的复发应提醒临床医生注意结核性心包炎的可能性。作者报告了一例27岁的白人男性病例，该患者人类免疫缺陷病毒血清学阳性，出现大量心包积液及异常超声心动图特征、全心衰且临床怀疑患有结核病。经过抗结核化疗和全身使用皮质类固醇后，临床症状有一定改善，但病情进展为缩窄性心包炎。该患者接受了心包切除术，效果良好。作者对人类免疫缺陷病毒血清学阳性和血清学阴性患者的缩窄性结核性心包炎进行了文献综述，讨论了皮质类固醇的作用以及不同诊断工具的贡献。
