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.

Overview

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. Finding acid fast bacilli on pericardiocentesis is confirmatory for tuberculous pericarditis.

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.