Submitted by IS:
What are your opinions regarding the use of adjuvant steroids for presumed TB pericarditis? Do you think a pericardial biopsy is a must if we have a positive PPD, negative cytology of fluid, low glucose on fluid studies, and good clinical history? Thanks.
Wednesday, August 08, 2007
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as far use of corticosteroids is concerned, this is controversial, published studies show that its use may have a tendency to decrease mortality but no benefit as far as reaccummulation of fluid and progression to constrictive pericarditis is concerned. i think incasse of suspicion of tb pericarditis , you give the anti-tb regimen and if no response look for other diseases
Agree. I guess it also depends upon the time course. Did the pateint present with pericarditis in their constellation of TB symptoms? or did the pericardidits occur after appropriate TB coverage had been instituted?
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