Is tuberculous pericarditis contagious? The truth is this

It is well known that tuberculous pericarditis is caused by tuberculosis infection, but most people do not know whether tuberculous pericarditis is contagious? The answer to this question is not very clear. In fact, tuberculous pericarditis is not contagious, but it is extremely harmful to human health, so everyone should not ignore it.

Tuberculous pericarditis is not contagious, but it is caused by intrathoracic lymph node tuberculosis, pleural or peritoneal tuberculosis, through lymph reflux infection or direct spread. The most common sources are the tracheal crossing lymph nodes near the pericardium, the aortic arch lymph nodes and the ductus arteriosus lymph nodes. Secondly, it may also be spread by hematogenous spread. When systemic miliary tuberculosis occurs, tuberculous nodules may be present in the pericardium, but this is less common. In addition, the caseous liquefied tuberculous lymph nodes near the pericardium may rupture directly into the pericardial cavity.

【Clinical manifestations】

1. The onset of exudative tuberculous pericarditis can be acute or slow. Among the 30 cases of exudative pericarditis, the shortest time from onset to hospitalization was 7 days and the longest was 1 year. Most of them have symptoms of systemic poisoning such as fever, loss of appetite, and weakness. The main early symptom is pain, which is mostly located under the sternum. It can be sharp pain, dull pain or tightness in the chest. Sometimes the pain radiates to the neck, shoulders, arms and upper abdomen, and is aggravated by inhalation, coughing or chest movement. As the exudate accumulates, the pain may decrease or disappear. Large amounts of pericardial effusion may cause symptoms of cardiac compression, such as dyspnea, dry cough, nausea, hoarseness, and lower limb edema. Physical signs include moderate or above heart enlargement, weakened apex beat, distant heart sounds, gallop rhythm, enlarged liver, ascites, lower limb edema, distended jugular veins, pulsus paradoxus, decreased pulse pressure, dilation of the jugular vein during inspiration, and a positive hepatojugular reflux sign. As pericardial effusion compresses the left lung base, signs of pulmonary consolidation such as dullness and bronchial breath sounds may appear in the left lower back. However, when the onset is slow, the exudate is small, or the exudate is large but accumulates very slowly, there may be no obvious symptoms of cardiac tamponade. In about half of the children, pericardial friction sound can be heard in the early stages of inflammation. Examination showed significantly elevated venous pressure.

2. Constrictive pericarditis has a slow onset and may be caused by the persistence of the acute exudative type. However, most cases are not discovered due to their hidden acute stage, and have become constrictive when they seek medical treatment. The time it takes to develop constrictive pericarditis can range from months to years. The youngest of our 12 cases was a 2-year-old child. Surgery confirmed that, in addition to the general symptoms, the main clinical symptoms were dyspnea and a series of symptoms and signs of cardiac tamponade. The main symptom is hepatomegaly, followed by ascites, lower limb edema, jugular vein distension, rales at the lung bases and cyanosis of the lips. Cardiovascular signs include weakened apex beat, reduced heart sounds, no increase in the size of cardiac dullness, decreased pulse pressure, pulsus paradoxus, and increased venous pressure.