PERICARDIAL TUBERCULOSIS: AN ESSENTIAL DIFFERENTIAL DIAGNOSIS IN PERICARDITIS

Abstract

Pericardial tuberculosis is a rare and potentially fatal form of extrapulmonary manifestation of tuberculosis, representing a diagnostic challenge, especially in endemic regions. This article reviews its clinical, epidemiological, and diagnostic aspects, based on literature published between 2012 and 2024. Pericardial infection with Mycobacterium tuberculosis occurs by hematogenous or lymphatic dissemination and can progress to cardiac tamponade or constrictive pericarditis. The clinical picture is insidious, with symptoms such as chest pain, dyspnea, and prolonged fever. Diagnosis requires clinical correlation and tests such as echocardiogram and pericardial fluid analysis, with elevated ADA being a useful marker. Treatment follows the standard tuberculosis regimen, and may include corticosteroids and invasive procedures in severe cases. Early recognition is essential to reduce the morbidity and mortality associated with this condition.