A case of tuberculous pericarditis : Importance of adenosine deaminase activity in pericardial fluid

Tetsurou Inoue M.D., Kanji Iga M.D., Kenjirou Hori M.D., Tadashi Matsumura M.D., Hiromitsu Gen M.D., Kazuhisa Kijima M.D., *Yoshiaki Koori M.D., *Takekuni Iwata M.D.

Abstract

We present a case of tuberculous pericarditis which was diagnosed early both by a high titer of adenosine deaminase activity in pericardial fluid and strongly positive tuberculin test. Within 2 weeks after the treatment, pericardial effusion gradually decreased while clinical symptoms improved markedly. Culture from sputum, gastric juice, urine, and the pericardial fluid were negative for tubercle bacillus. Measurement of adenosine deaminase activity in pericardial fluid is as important a supplementary diagnostic test for tuberculous pericarditis as it is for tuberculous pleuritis, because negative Ziehl Neelsen staining and culture for tubercle bacillus are common in tuberculous pericarditis.