Вот что я нашла по поводу туберкулезного перикардита
Цитата:
Tuberculous pericarditis
In the last decade TBC pericarditis in the developed countries has been primarily seen in immunocompromised patients (AIDS).123 The mortality rate in untreated acute effusive TBC pericarditis approaches 85%. Pericardial constriction occurs in 30–50%.122,125 The clinical presentation is variable: acute pericarditis with or without effusion; cardiac tamponade, silent, often large pericardial effusion with a relapsing course, toxic symptoms with persistent fever, acute constrictive pericarditis, subacute constriction, effusive-constrictive, or chronic constrictive pericarditis, and pericardial calcifications.3,89 The diagnosis is made by the identification of Mycobacterium tuberculosis in the pericardial fluid or tissue, and/or the presence of caseous granulomas in the pericardium.3,123 Importantly, PCR can identify DNA of Mycobacterium tuberculosis rapidly from only 1 µL of pericardial fluid.127,128 High adenosine deaminase activity and interferon gamma concentration in pericardial effusion are also diagnostic, with a high sensitivity and specificity (Focus box 3): Both pericardioscopy and pericardial biopsy have also improved the diagnostic accuracy for TBC pericarditis.15 Pericardial biopsy enables rapid diagnosis with better sensitivity than pericardiocentesis (100 vs. 33%).
Pericarditis in a patient with proven extracardiac tuberculosis is strongly suggestive of TBC aetiology (several sputum cultures should be taken).3,126 The tuberculin skin test may be false negative in 25–33% of tests122 and false positive in 30–40% of patients.123 More accurate enzyme-linked immunospot (ELISPOT) test detects T-cells specific for Mycobacterium tuberculosis antigen.132 Perimyocardial TBC involvement is also associated with high serum titres of antimyolemmal and antimyosin antibodies.133 The diagnostic yield of pericardiocentesis in TBC pericarditis ranges from 30–76% according to the methods applied for the analyses of pericardial effusion.122,127 Pericardial fluid demonstrates high specific gravity, high protein levels, and high white-cell count (from 0.7–54x109/l).123
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НЕоднократно делали ПЦР в жидкости, полученной из перикарда и плевральной полости. Гистология ничего не дала. Все равно подозреваем tbc? Что нам даст проба Манту в таком случае?
Сейчас попробую позвать Аннабеллу.