Tuberculous pericarditis in adolescents: A case series

  • Winda Paramitha Universitas Gadjah Mada
  • Indah Kartika Murni Universitas Gadjah Mada
  • Eggi Arguni Universitas Gadjah Mada
  • Dwikisworo Setyowireni Universitas Gadjah Mada
Keywords: tuberculous pericarditis; adolescents; pericardial effusion


Tuberculosis (TB) is one of the major causes of childhood mortality, especially in endemic areas. In 2013, the World Health Organization (WHO) estimated 550,000 new cases and 80,000 deaths due to TB among children. Around 70-80% of the cases were pulmonary TB, while the rest were extra-pulmonary TB.1

Tuberculous pericarditis accounts for only 8% of all TB cases, however, tuberculosis is the main cause of pericarditis in high-TB-burden countries, including Indonesia.2 The mortality rate reached 17-40% and is affected by treatment adequacy.3 Without adequate therapy, the mean life expectancy is 3.7 months, with only 20% surviving to the sixth month.4 A 2004 study reported that successful treatment of TB in children depends on several factors, such as treatment compliance, timing and accuracy of diagnosis, concurrent human immunodeficency virus (HIV) infection and its clinical stage of disease, malnutrition, and drug resistance.5 Adolescents and young adults are at the highest risks of having TB.6 We report here on three cases of tuberculous pericarditis in adolescents and their outcomes following pericardiocentesis and medication.


1. World Health Organization. Global tuberculosis report 2014 [Internet]. World Health Organization. 2014. [cited 2018 October 21]. Available from:
2. Mayosi BM, Wiysonge CS, Ntsekhe M, Volmink JA, Gumedze F, Maartens G, et al. Clinical characteristics and initial management of patients with tuberculous pericarditis in the HIV era: The Investigation of the Management of Pericarditis in Africa (IMPI Africa) registry. BMC Infect Dis. 2006;6:1-9. DOI: 10.1186/1471-2334-6-2.
3. Syed FF, Mayosi BM. A modern approach to tuberculous pericarditis. Prog Cardiovasc Dis. 2007;50:218-36. DOI:10.1016/j.pcad.2007.03.002.
4. Cherian G. Diagnosis of tuberculous aetiology in pericardial effusions. Postgrad Med J. 2004;80:262-6. DOI: 0.1136/pgmj.2003.013664.
5. Swaminathan S, Rekha B. Pediatric tuberculosis: Global overview and challenges. Clin Infect Dis. 2010;50:S184-94. DOI:10.1086/651490.
6. Snow KJ, Sismanidis C, Denholm J, Sawyer SM, Graham SM. The incidence of tuberculosis among adolescents and young adults: a global estimate. Eur Respir J. 2018;51:1702352. DOI: 10.1183/13993003.02352-2017.
7. Sainani GS, Sainani R. Tuberculous pericardial effusion. Indian J Clin Pract. 2012;22:371-4.
8. Mayosi BM, Burgess L, Doubell AF. Tuberculous pericarditis. Circulation. 2005;112:3608-16. DOI: 10.1161/CIRCULATIONAHA.105.543066.
9. Wallgreen A. The time-table of tuberculosis. Tubercle. 1948;29:245-51. DOI:10.1016/s0041-3879(48)80033-4.
10. Collins D. Aetiology and management of acute cardiac tamponade. Crit Care Resusc. 2004;6:54-8. PMID: PMID: 16563105.
11. Strang JIG, Gibson DG, Nunn AJ, Kakaza HHS, Fox W. Controlled trial of prednisolone as adjuvant in treatment of tuberculous constrictive pericarditis in Transkei. Lancet. 1987;2:1418-22. DOI: 10.1016/s0140-6736(87)91127-5.
12. Cs W, Ntsekhe M, Thabane L, Volmink J, Majombozi D, Gumedze F, et al. Interventions for treating tuberculous pericarditis ( Review ). Cochrane Database Syst Rev. 2017;9:1-65. DOI: 10.1002/14651858.CD000526.pub2.
How to Cite
Paramitha W, Murni I, Arguni E, Setyowireni D. Tuberculous pericarditis in adolescents: A case series. PI [Internet]. 25Feb.2020 [cited 13Jul.2024];60(2):111-. Available from:
Case Report
Received 2019-02-08
Accepted 2020-02-25
Published 2020-02-25