Tuberculous pericarditis
Article Abstract:
Since the beginning of the century mortality from tuberculosis has declined from 202 per 100,000 population to 9 per 100,000 population in the United States. However, it is still a major cause of death in developing countries, and has begun to increase in the United States because acquired immunodeficiency syndrome (AIDS) has made many more people susceptible to infection. One of the most serious complications of tuberculosis is pericarditis (inflammation of the membranous sac surrounding the heart). The development and progression of tuberculous pericarditis are described, and the findings from a physical examination and from laboratory tests for diagnosis are discussed. The infection underlying tuberculous pericarditis is treated with the drug rifampin, given in combination with other drugs. Corticosteroids may also be helpful. If the growth of fibrous tissue begins to constrict the heart, or if removal of fluid in the pericardium does not lower blood pressure in the veins, pericardiectomy (surgical removal of the pericardial sac) may be necessary. Although some physicians recommend pericardiectomy for all patients with tuberculous pericarditis, others do not. In one study, only 17 of 240 patients required the surgery, and in another, drug therapy alone was effective in 30 of 41 patients. Surgery is not recommended for routine treatment. Mortality among patients with tuberculous pericarditis is now below 50 percent. However, whether drug therapy prevents constrictive pericarditis is still not clear. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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Severe measles in immunocompromised patients
Article Abstract:
Patients who are immunocompromised may have more severe complications of measles than healthy individuals. Out of nine immunocompromised patients with measles, eight developed severe complications and two died. Two patients did not have a rash. Seven of the patients with severe complications had inflammation of the lungs. They were treated with ribavirin and corticosteroids. When these patients were compared to reports of immunocompromised patients with measles in the literature, 80% of the patients had severe complications, and 30% did not have a rash. Most of the reports in the literature were of measles in cancer patients, who often take immunosuppressive drugs, or HIV-infected individuals. According to the literature, survival rates were higher in HIV-infected individuals who had been vaccinated against measles.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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