The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV
Aims : To establish the influence of human immunodeficiency virus (HIV) infection on the histopathological features of patients presenting with tuberculous pericarditis. Methods and results : A prospective study was carried out at Tygerberg Academic Hospital, South Africa; 36 patients with large per...
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| Veröffentlicht in: | Histopathology 2006-02, Vol.48 (3), p.295-302 |
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| creator | Reuter, H Burgess, L J Schneider, J Van Vuuren, W Doubell, A F |
| description | Aims : To establish the influence of human immunodeficiency virus (HIV) infection on the histopathological features of patients presenting with tuberculous pericarditis.
Methods and results : A prospective study was carried out at Tygerberg Academic Hospital, South Africa; 36 patients with large pericardial effusions had open pericardial biopsies under general anaesthesia and were included in the study. Patients underwent pericardiocentesis, followed by daily intermittent catheter drainage; a comprehensive diagnostic work‐up (including histopathology of the pericardial tissue) was also performed. Histological tuberculous pericarditis was diagnosed according to predetermined criteria. Tuberculous pericarditis was identified in 25 patients, five of whom were HIV+. The presence of granulomatous inflammation (with or without necrosis) and/or Ziehl–Neelsen positivity yielded the best test results (sensitivity 64%, specificity 100% and diagnostic efficiency 75%).
Conclusions : Co‐infection with HIV impacts on the histopathological features of pericardial tuberculosis and leads to a decrease in the sensitivity of the test. In areas which have a high prevalence of tuberculosis, the combination of a sensitive test such as adenosine deaminase, chest X‐ray and clinical features has a higher diagnostic efficiency than pericardial biopsy in diagnosing tuberculous pericarditis. |
| doi_str_mv | 10.1111/j.1365-2559.2005.02320.x |
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Methods and results : A prospective study was carried out at Tygerberg Academic Hospital, South Africa; 36 patients with large pericardial effusions had open pericardial biopsies under general anaesthesia and were included in the study. Patients underwent pericardiocentesis, followed by daily intermittent catheter drainage; a comprehensive diagnostic work‐up (including histopathology of the pericardial tissue) was also performed. Histological tuberculous pericarditis was diagnosed according to predetermined criteria. Tuberculous pericarditis was identified in 25 patients, five of whom were HIV+. The presence of granulomatous inflammation (with or without necrosis) and/or Ziehl–Neelsen positivity yielded the best test results (sensitivity 64%, specificity 100% and diagnostic efficiency 75%).
Conclusions : Co‐infection with HIV impacts on the histopathological features of pericardial tuberculosis and leads to a decrease in the sensitivity of the test. In areas which have a high prevalence of tuberculosis, the combination of a sensitive test such as adenosine deaminase, chest X‐ray and clinical features has a higher diagnostic efficiency than pericardial biopsy in diagnosing tuberculous pericarditis.</description><identifier>ISSN: 0309-0167</identifier><identifier>EISSN: 1365-2559</identifier><identifier>DOI: 10.1111/j.1365-2559.2005.02320.x</identifier><identifier>PMID: 16430476</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Adenosine Deaminase - analysis ; AIDS-Related Opportunistic Infections - diagnosis ; AIDS-Related Opportunistic Infections - pathology ; Bacterial diseases ; Biological and medical sciences ; Biopsy ; histopathology ; HIV ; HIV Infections - complications ; HIV Infections - diagnosis ; HIV Infections - pathology ; HIV Infections - virology ; HIV-1 - isolation & purification ; Human bacterial diseases ; Human immunodeficiency virus ; Humans ; Infectious diseases ; Investigative techniques, diagnostic techniques (general aspects) ; Medical sciences ; Mycobacterium ; Mycobacterium tuberculosis - isolation & purification ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Pericarditis, Tuberculous - complications ; Pericarditis, Tuberculous - diagnosis ; Pericarditis, Tuberculous - microbiology ; Pericarditis, Tuberculous - pathology ; Pericardium - microbiology ; Pericardium - pathology ; Pericardium - virology ; Prospective Studies ; Sensitivity and Specificity ; Tuberculosis and atypical mycobacterial infections ; tuberculous pericarditis</subject><ispartof>Histopathology, 2006-02, Vol.48 (3), p.295-302</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4660-61b922ca2c8f5d75bc8c1ae7440c3ecd2ca5d5b30075418d06dd041bb106466d3</citedby><cites>FETCH-LOGICAL-c4660-61b922ca2c8f5d75bc8c1ae7440c3ecd2ca5d5b30075418d06dd041bb106466d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2559.2005.02320.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2559.2005.02320.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17570195$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16430476$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reuter, H</creatorcontrib><creatorcontrib>Burgess, L J</creatorcontrib><creatorcontrib>Schneider, J</creatorcontrib><creatorcontrib>Van Vuuren, W</creatorcontrib><creatorcontrib>Doubell, A F</creatorcontrib><title>The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV</title><title>Histopathology</title><addtitle>Histopathology</addtitle><description>Aims : To establish the influence of human immunodeficiency virus (HIV) infection on the histopathological features of patients presenting with tuberculous pericarditis.
Methods and results : A prospective study was carried out at Tygerberg Academic Hospital, South Africa; 36 patients with large pericardial effusions had open pericardial biopsies under general anaesthesia and were included in the study. Patients underwent pericardiocentesis, followed by daily intermittent catheter drainage; a comprehensive diagnostic work‐up (including histopathology of the pericardial tissue) was also performed. Histological tuberculous pericarditis was diagnosed according to predetermined criteria. Tuberculous pericarditis was identified in 25 patients, five of whom were HIV+. The presence of granulomatous inflammation (with or without necrosis) and/or Ziehl–Neelsen positivity yielded the best test results (sensitivity 64%, specificity 100% and diagnostic efficiency 75%).
Conclusions : Co‐infection with HIV impacts on the histopathological features of pericardial tuberculosis and leads to a decrease in the sensitivity of the test. In areas which have a high prevalence of tuberculosis, the combination of a sensitive test such as adenosine deaminase, chest X‐ray and clinical features has a higher diagnostic efficiency than pericardial biopsy in diagnosing tuberculous pericarditis.</description><subject>Adenosine Deaminase - analysis</subject><subject>AIDS-Related Opportunistic Infections - diagnosis</subject><subject>AIDS-Related Opportunistic Infections - pathology</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>histopathology</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - pathology</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - isolation & purification</subject><subject>Human bacterial diseases</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical sciences</subject><subject>Mycobacterium</subject><subject>Mycobacterium tuberculosis - isolation & purification</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Pericarditis, Tuberculous - complications</subject><subject>Pericarditis, Tuberculous - diagnosis</subject><subject>Pericarditis, Tuberculous - microbiology</subject><subject>Pericarditis, Tuberculous - pathology</subject><subject>Pericardium - microbiology</subject><subject>Pericardium - pathology</subject><subject>Pericardium - virology</subject><subject>Prospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>tuberculous pericarditis</subject><issn>0309-0167</issn><issn>1365-2559</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUFv0zAUxy0EYmXwFVAucEt4tmM7OXBgE1srDTgwhsTFchyndXHjzE5E--1x1mo7gi-29H7_9571QyjDUOB0PmwLTDnLCWN1QQBYAYQSKPbP0OKx8BwtgEKdA-biDL2KcQuABSXkJTrDvKRQCr5A4-3GZME7k_ku29g4-kGNG-_8-pDZPjNxVI2zcWP7dTYmtLVq3fto48yPU2OCnpyfYjaYYLUKqe4y03VTtL6Pc4s5NQQTTa8fhixXd6_Ri065aN6c7nP04-rz7eUyv_l2vbr8dJPrknPIOW5qQrQiuupYK1ijK42VEWUJmhrdphJrWUMBBCtx1QJvWyhx02DgqUFLz9H7Y98h-Psp_UXubNTGOdWbtLMUIDCrK_JPkEBViRLXCayOoA4-xmA6OQS7U-EgMchZjdzK2YCcDchZjXxQI_cp-vY0Y2p2pn0Knlwk4N0JUFEr1wXVaxufOMEE4Jol7uOR-2OdOfz3AnK5-j6_Uj4_5pNts3_Mq_BbckEFkz-_Xsuri7svF5z_kkv6F9MGugY</recordid><startdate>200602</startdate><enddate>200602</enddate><creator>Reuter, H</creator><creator>Burgess, L J</creator><creator>Schneider, J</creator><creator>Van Vuuren, W</creator><creator>Doubell, A F</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200602</creationdate><title>The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV</title><author>Reuter, H ; Burgess, L J ; Schneider, J ; Van Vuuren, W ; Doubell, A F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4660-61b922ca2c8f5d75bc8c1ae7440c3ecd2ca5d5b30075418d06dd041bb106466d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adenosine Deaminase - analysis</topic><topic>AIDS-Related Opportunistic Infections - diagnosis</topic><topic>AIDS-Related Opportunistic Infections - pathology</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>histopathology</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - pathology</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - isolation & purification</topic><topic>Human bacterial diseases</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical sciences</topic><topic>Mycobacterium</topic><topic>Mycobacterium tuberculosis - isolation & purification</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Pericarditis, Tuberculous - complications</topic><topic>Pericarditis, Tuberculous - diagnosis</topic><topic>Pericarditis, Tuberculous - microbiology</topic><topic>Pericarditis, Tuberculous - pathology</topic><topic>Pericardium - microbiology</topic><topic>Pericardium - pathology</topic><topic>Pericardium - virology</topic><topic>Prospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>tuberculous pericarditis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reuter, H</creatorcontrib><creatorcontrib>Burgess, L J</creatorcontrib><creatorcontrib>Schneider, J</creatorcontrib><creatorcontrib>Van Vuuren, W</creatorcontrib><creatorcontrib>Doubell, A F</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Histopathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reuter, H</au><au>Burgess, L J</au><au>Schneider, J</au><au>Van Vuuren, W</au><au>Doubell, A F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV</atitle><jtitle>Histopathology</jtitle><addtitle>Histopathology</addtitle><date>2006-02</date><risdate>2006</risdate><volume>48</volume><issue>3</issue><spage>295</spage><epage>302</epage><pages>295-302</pages><issn>0309-0167</issn><eissn>1365-2559</eissn><abstract>Aims : To establish the influence of human immunodeficiency virus (HIV) infection on the histopathological features of patients presenting with tuberculous pericarditis.
Methods and results : A prospective study was carried out at Tygerberg Academic Hospital, South Africa; 36 patients with large pericardial effusions had open pericardial biopsies under general anaesthesia and were included in the study. Patients underwent pericardiocentesis, followed by daily intermittent catheter drainage; a comprehensive diagnostic work‐up (including histopathology of the pericardial tissue) was also performed. Histological tuberculous pericarditis was diagnosed according to predetermined criteria. Tuberculous pericarditis was identified in 25 patients, five of whom were HIV+. The presence of granulomatous inflammation (with or without necrosis) and/or Ziehl–Neelsen positivity yielded the best test results (sensitivity 64%, specificity 100% and diagnostic efficiency 75%).
Conclusions : Co‐infection with HIV impacts on the histopathological features of pericardial tuberculosis and leads to a decrease in the sensitivity of the test. In areas which have a high prevalence of tuberculosis, the combination of a sensitive test such as adenosine deaminase, chest X‐ray and clinical features has a higher diagnostic efficiency than pericardial biopsy in diagnosing tuberculous pericarditis.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>16430476</pmid><doi>10.1111/j.1365-2559.2005.02320.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Adenosine Deaminase - analysis AIDS-Related Opportunistic Infections - diagnosis AIDS-Related Opportunistic Infections - pathology Bacterial diseases Biological and medical sciences Biopsy histopathology HIV HIV Infections - complications HIV Infections - diagnosis HIV Infections - pathology HIV Infections - virology HIV-1 - isolation & purification Human bacterial diseases Human immunodeficiency virus Humans Infectious diseases Investigative techniques, diagnostic techniques (general aspects) Medical sciences Mycobacterium Mycobacterium tuberculosis - isolation & purification Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Pericarditis, Tuberculous - complications Pericarditis, Tuberculous - diagnosis Pericarditis, Tuberculous - microbiology Pericarditis, Tuberculous - pathology Pericardium - microbiology Pericardium - pathology Pericardium - virology Prospective Studies Sensitivity and Specificity Tuberculosis and atypical mycobacterial infections tuberculous pericarditis |
| title | The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV |
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