Inoue T, Iga K, Hori K, Matsumura T, Gen H, Kijima K, Kohri Y, Iwata T
Department of Cardiology, Tenri Hospital, Nara, Japan.
Intern Med. 1993 Aug;32(8):675-7. doi: 10.2169/internalmedicine.32.675.
We present a case of tuberculous pericarditis that was diagnosed early by a high titer of adenosine deaminase activity in the pericardial fluid and by a strongly positive tuberculin test. Within 2 weeks of initiation of treatment, pericardial effusion gradually decreased while clinical symptoms improved markedly. Culture from sputum, gastric juice, urine, and pericardial fluid were negative for tubercle bacillus. Measurement of adenosine deaminase activity in the pericardial fluid is a supplementary diagnostic test which is as important as for tuberculous pericarditis as it is for tuberculous pleuritis, because negative Ziehl Neelsen staining and culture for tubercle bacillus are common in tuberculous pericarditis.
我们报告一例结核性心包炎病例，该病例通过心包液中高滴度的腺苷脱氨酶活性以及结核菌素试验强阳性得以早期诊断。在开始治疗的2周内，心包积液逐渐减少，同时临床症状明显改善。痰液、胃液、尿液和心包液的培养均未发现结核杆菌。心包液中腺苷脱氨酶活性的测定是一项辅助诊断试验，对于结核性心包炎而言，其重要性与结核性胸膜炎相同，因为结核性心包炎中结核杆菌的萋尼染色和培养结果通常为阴性。
