Prednisolone and Mycobacterium indicus pranii in Tuberculous Pericarditis

In this trial, patients with tuberculous pericarditis were randomly assigned to prednisolone or placebo and to Mycobacterium indicus pranii or placebo. Neither therapy reduced the risk of the composite outcome of death, cardiac tamponade, or constrictive pericarditis. Tuberculous pericarditis is a common cause of pericardial effusion, cardiac tamponade, and constrictive pericarditis in sub-Saharan Africa and parts of Asia. 1 – 3 Patients with tuberculous pericarditis often have concomitant human immunodeficiency virus (HIV) infection. 1 Despite antituberculosis therapy, pericardial drainage, or pericardiectomy, mortality and morbidity remain high. 4 Mortality is as high as 26% at 6 months but is even higher (approximately 40%) among persons with the acquired immunodeficiency syndrome. 5 The use of glucocorticoid therapy in patients with tuberculous pericarditis to attenuate the inflammatory response may improve outcomes and decrease the risk of death by reducing cardiac tamponade and pericardial constriction, 6 but . . .