Difference between revisions of "Tuberculous pericarditis differential diagnosis"

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On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
 
On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
 +
{|
 +
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
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! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
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| colspan="5" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
 +
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
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| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
 +
|-
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| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
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! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
 +
|-
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! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
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! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology and imaging
 +
|-
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Chest pain
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! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Jugular vein
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dry cough with hemoptesis
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Friction rub
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! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lymph-adenopathy
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sputom cuture
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histological demonestration
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|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Tuberculosis
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |elevated
 +
| style="background: #F5F5F5; padding: 5px;" |If +, increases the risk
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+/-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |Active caseating granuloma in lungs
 +
| style="background: #F5F5F5; padding: 5px;" |Treat all HIV induced pericarditis for tuberclosis. if not clinically improved, search for other diseases.
 +
|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Congestive cardiomypathy
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |not elevated
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |Causes detectable CXR changes.
 +
| style="background: #F5F5F5; padding: 5px;" |
 +
|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |pneumocystis
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |Detectable by unique shape and pathologic features
 +
| style="background: #F5F5F5; padding: 5px;" |
 +
|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |CMV
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |Detecting pathologic giant CD8+ T-cell
 +
| style="background: #F5F5F5; padding: 5px;" |
 +
|-
 +
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Kaposi sarcoma
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |Specific skin and GI manifestations
 +
| style="background: #F5F5F5; padding: 5px;" |
 +
|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Lymphoma
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |-
 +
| style="background: #F5F5F5; padding: 5px;" |+
 +
| style="background: #F5F5F5; padding: 5px;" |Lymph node excision and frozen section manifest unique features
 +
| style="background: #F5F5F5; padding: 5px;" |
 +
|}
 +
 +
 
{|
 
{|
 
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
 
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"

Revision as of 17:44, 4 December 2019

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Tuberculous pericarditis Microchapters

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Differentiating Tuberculous pericarditis from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Differentiating [Disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].

OR

As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examination
Lab Findings Histopathology and imaging
Chest pain Jugular vein Dry cough with hemoptesis Friction rub Lymph-adenopathy Sputom cuture Histological demonestration
Tuberculosis + elevated If +, increases the risk + +/- + - Active caseating granuloma in lungs Treat all HIV induced pericarditis for tuberclosis. if not clinically improved, search for other diseases.
Congestive cardiomypathy + not elevated - - - - - Causes detectable CXR changes.
pneumocystis + + - + - + - Detectable by unique shape and pathologic features
CMV + + - + + - + Detecting pathologic giant CD8+ T-cell
Kaposi sarcoma + + - + + - + Specific skin and GI manifestations
Lymphoma + + - + + - + Lymph node excision and frozen section manifest unique features


Diseases Diagnostic tests Physical Examination Symptoms Past medical history Other Findings
CT scan and MRI EKG Chest X-ray Tachypnea Tachycardia Fever Chest Pain Hemoptysis Dyspnea on Exertion Wheezing Chest Tenderness Nasalopharyngeal Ulceration Carotid Bruit
Pulmonary embolism
  • On CT angiography:
    • Intra-luminal filling defect
  • On MRI:
    • Narrowing of involved vessel
    • No contrast seen distal to obstruction
    • Polo-mint sign (partial filling defect surrounded by contrast)
✔ (Low grade) ✔ (In case of massive PE) - - - -
Congestive heart failure
  • Goldberg's criteria may aid in diagnosis of left ventricular dysfunction: (High specificity)
    • SV1 or SV2 + RV5 or RV6 ≥3.5 mV
    • Total QRS amplitude in each of the limb leads ≤0.8 mV
    • R/S ratio <1 in lead V4
- - - - - -
Percarditis
  • ST elevation
  • PR depression
  • Large collection of fluid inside the pericardial sac (pericardial effusion)
  • Calcification of pericardial sac
✔ (Low grade) ✔ (Relieved by sitting up and leaning forward) - - - - -
  • May be clinically classified into:
    • Acute (< 6 weeks)
    • Sub-acute (6 weeks - 6 months)
    • Chronic (> 6 months)
Pneumonia - - - -
Vasculitis

Homogeneous, circumferential vessel wall swelling

-
Chronic obstructive pulmonary disease (COPD)
  • On CT scan:
  • On MRI:
    • Increased diameter of pulmonary arteries
    • Peripheral pulmonary vasculature attentuation
    • Loss of retrosternal airspace due to right ventricular enlargement
    • Hyperpolarized Helium MRI may show progressively poor ventilation and destruction of lung
- - - - - -

References


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