Tuberculous pericarditis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview


Differentiating [Disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].

OR

As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
History Symptoms Physical examination
Lab Findings Imaging Histopathology
Chest pain Fever Cough Edema/Ascites JVP Heart/Lung sounds Hepatomegaly Splenomegaly Lab 1 CXR CT Scan MRI Echo/Sono
Constrictive pericarditis
Tuberculosis[1][2][2]
  • Close contact with TB+ person
+ + + ± +
  • Miled anemia
  • Leukocytosis
  • Pleural effusion
  • Pericardial calcification
  • Pericardial thickening
  • Pericardial effusion
  • Evidence of pulmonary TB
  • Enlarged cardiac silhouette
  • Pericardial effusion
  • Pericardial thickening
  • Mediastinal and tracheobronchial lymphadenopathy (with hilar sparing)
  • Bowing of the interventricular septum toward the left ventricle during diastole
  • Acid fast bacilli
Idiopathic/Viral
  • Recent common cold
+ ± ±
Post cardiac surgery
  • Cardiac surgery
Post radiation
  • Radiation
Connective tissue disease
Malignancy
  • History of known malignancy
+ ±
  • Ankle edema
+ Increased:
  • Pericardial calcifications
  • Enlarged cardiac silhouette
Mesothelioma[3]
Chronic renal failure
Asbestosis
Restrictive cardiomyopathy
Amyloidosis[4]
Sarcoidosis
Hemochromatosis
Sclerodema
Endomyocardial fibrosis
Carcinoid heart disease
Post radiation
Diabetic cardiomyopathy
Hurler
Gaucher
Fabry
Wegener
Metastatic malignancies

References

  1. Rooney JJ, Crocco JA, Lyons HA (January 1970). "Tuberculous pericarditis". Ann. Intern. Med. 72 (1): 73–81. doi:10.7326/0003-4819-72-1-73. PMID 5410398.
  2. 2.0 2.1 Cherian G (May 2004). "Diagnosis of tuberculous aetiology in pericardial effusions". Postgrad Med J. 80 (943): 262–6. doi:10.1136/pgmj.2003.013664. PMC 1742992. PMID 15138314.
  3. Radiographic findings of mesothelioma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/mesothelioma. Accessed on February 8, 2015
  4. Falk RH, Quarta CC, Dorbala S (2014). "How to image cardiac amyloidosis". Circ Cardiovasc Imaging. 7 (3): 552–62. doi:10.1161/CIRCIMAGING.113.001396. PMC 4118308. PMID 24847009.

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