Tuberculous Pericarditis: The Effect of Streptomycin

Abstract

Thirteen cases of tuberculous penicarditis with effusion treated with streptomycin are presented. Tubercle bacilli were recovered from the pericardium in only two. The diagnosis in the others is based on strong presumptive evidence. Four died within two years of the onset, while nine are living 13 months to almost six years after the onset of pericarditis. Clinical evidence of constrictive pericarditis developed in two of the patients who died, is present in two of the living patients. When constrictive pericarditis was evident cardiac failure occurred early in the course of the disease, soon after absorption of fluid. Those who were asymptomatic after one year continued to have no cardiac difficulty. Comparison with other reports in the literature suggests that the prognosis is improved as streptomycin treatment shortens the course of the acute disease, decreases the number of deaths from other forms of tuberculosis, and may lessen the incidence of constrictive pericarditis. It is noted that variation in the severity of the disease makes it difficult to estimate the mortality rate and prognosis, and makes such comparison with the literature somewhat unreliable.