Outcome of Significant Pericardial Effusion of Infectious Etiology in Children: an Observational Retrospective Cohort Study

Abstract

Information on outcome of pediatric pericardial diseases from India is limited. The aim of this study is to study the outcome of significant pericardial effusion of infectious etiology in children. This study is a retrospective analysis of significant pericardial effusion of infectious etiology in children admitted to a tertiary care hospital of northern India during the last 10 years. Of the 74 patients, 71.6% (53/74) had tuberculosis, most being “probable” tubercular effusion. Pyogenic cases (17/74) usually had a pleura-pulmonary focus. Pericardial fluid adenosine deaminase (ADA) and contrast enhanced computer tomography (CECT) chest were useful diagnostic aids in tubercular effusions. Pericardiocentesis and surgery were done in 72.9% (54/74) and 12.1% (9/74), respectively. On median follow-up of 18 months, death or chronic constrictive pericarditis was seen in 2 patients each, both had tubercular effusions. Tuberculosis is still the commonest infectious cause of pericardial effusion in children from this part of the world. Introduction of early intervention with pericaridiocentesis or surgery may improve the outcome of this once deadly disease.