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Article ; Online: Cardiac Tuberculosis: A Case Series from Ethiopia, Italy, and Uganda and a Literature Review.

Cotugno, Sergio / Guido, Giacomo / Manco Cesari, Giorgia / Ictho, Jerry / Lochoro, Peter / Amone, James / Segala, Francesco Vladimiro / De Vita, Elda / Lattanzio, Rossana / Okori, Samuel / De Iaco, Giuseppina / Girma, Adisu / Sura, Abata / Hessebo, Eriballo Tariku / Balsemin, Franco / Putoto, Giovanni / Ronga, Luigi / Manenti, Fabio / Facci, Enzo /
Saracino, Annalisa / Di Gennaro, Francesco

The American journal of tropical medicine and hygiene

2024  Volume 110, Issue 4, Page(s) 795–804

Abstract: Extrapulmonary tuberculosis (TB) is estimated to account for up to 20% of active cases of TB disease, but its prevalence is difficult to ascertain because of the difficulty of diagnosis. Involvement of the heart is uncommon, with constrictive ... ...

Abstract Extrapulmonary tuberculosis (TB) is estimated to account for up to 20% of active cases of TB disease, but its prevalence is difficult to ascertain because of the difficulty of diagnosis. Involvement of the heart is uncommon, with constrictive pericarditis being the most common cardiac manifestation. Diagnostic research for cardiac disease is frequently lacking, resulting in a high mortality rate. In addition to direct cardiac involvement, instances of cardiac events during antitubercular therapy are described. This case series describes five cases of TB affecting the heart (cardiac TB) from Italy and high-burden, low-income countries (Ethiopia and Uganda), including a case of Loeffler syndrome manifesting as myocarditis in a patient receiving antitubercular therapy. Our study emphasizes how cardiac TB, rare but important in high-burden areas, is a leading cause of pericardial effusion or pericarditis. Timely diagnosis and a comprehensive approach, including imaging and microbiological tools, are crucial. Implementing high-sensitivity methods and investigating alternative samples, such as detection of tuberculosis lipoarabinomannan or use of the GeneXpert assay with stool, is recommended in TB control programs.
MeSH term(s) Humans ; Ethiopia/epidemiology ; Uganda ; Antitubercular Agents/therapeutic use ; Tuberculosis/diagnosis ; Tuberculosis/drug therapy ; Tuberculosis/complications ; Pericardial Effusion/diagnosis ; Pericardial Effusion/drug therapy ; Pericardial Effusion/etiology ; Mycobacterium tuberculosis
Chemical Substances Antitubercular Agents
Language English
Publishing date 2024-02-27
Publishing country United States
Document type Review ; Case Reports ; Journal Article
ZDB-ID 2942-7
ISSN 1476-1645 ; 0002-9637
ISSN (online) 1476-1645
ISSN 0002-9637
DOI 10.4269/ajtmh.23-0505
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