PDF(Pubmed)
Abstract：
Tuberculous pericarditis (TBP) is an important cause of pericarditis worldwide while being infrequent in childhood, especially in low-TB-incidence countries. We report a case of TBP and provide a systematic review of the literature, conducted by searching PubMed, Scopus, and Cochrane to find cases of TBP in pediatric age published in the English language between the year 1990 and the time of the search. Of the 587 search results obtained, after screening and a backward citation search, 45 studies were selected to be included in this review, accounting for a total of 125 patients. The main signs and symptoms were fever, cough, weight loss, hepatomegaly, dyspnea, and increased jugular venous pressure or jugular vein turgor. A definitive diagnosis of TBP was made in 36 patients, either thanks to microbiological investigations, histological analysis, or both. First-line antitubercular treatment (ATT) was administered in nearly all cases, and 69 children underwent surgical procedures. Only six patients died, and only two died of TBP. TBP in childhood is relatively uncommon, even in high-TB-prevalence countries. Clinical manifestations, often suggestive of right-sided cardiac failure, are subtle, and diagnosis is challenging. TBP has an excellent prognosis in childhood; however, in a significant proportion of cases, invasive surgical procedures are necessary.
摘要：
结核性心包炎（TBP）是全球范围内心包炎的重要原因，但在儿童期很少见。尤其是在结核病发病率低的国家。我们报告了一例TBP，并对文献进行了系统的回顾，通过搜索PubMed，Scopus,和Cochrane查找1990年至搜索时间之间以英语发表的儿科年龄的TBP病例。在获得的587个搜索结果中，经过筛选和向后引用搜索，选择了45项研究纳入本综述，患者共125例。主要症状和体征是发烧，咳嗽,减肥,肝肿大,呼吸困难,颈静脉压升高或颈静脉扩张。对36例患者进行了TBP的明确诊断，要么归功于微生物调查，组织学分析,或者两者兼而有之。一线抗结核治疗（ATT）在几乎所有的情况下，69名儿童接受了外科手术。只有六个病人死了,只有两个人死于TBP.儿童时期的TBP相对少见，即使在高结核病流行率国家。临床表现,通常提示右侧心力衰竭，是微妙的，诊断是具有挑战性的。TBP在儿童时期有很好的预后；然而，在很大一部分案件中，侵入性外科手术是必要的。
