Tuberculous pericarditis diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Diagnostic Study of Choice

Study of choice

• Pericardiocentesis is the gold standard test for the diagnosis of tuberculous pericarditis.
• Pericardial biopsy must be performed when:
  • We can't find acid fast bacilli in sputum or pericardial fluid.

Diagnostic results

The following finding on pericardiocentesis is confirmatory for tuberculous pericarditis:

• Acid fast bacilli

Sequence of Diagnostic Studies

The various investigations must be performed in the following order:

• Imaging (CXR, CT scan, MRI)
• Echocardiography
• Evaluation of sputum for acid-fast bacilli (AFB)
• Evaluation of pericardial fluid for acid-fast bacilli (AFB)
• Lymph node biopsy
• Pericardial biopsy

Diagnostic Criteria

There are no established criteria for the diagnosis of tuberculous pericarditis.