Tuberculosis infection of the membrane around the the heart is uncommon but life threatening. There is little reliable research on best practice in relation to what drugs to give and when and how to operate. Currently doctors prescribe antituberculous drugs and remove the membrane if it is making the patient ill. However, doctors vary in the way they manage this condition in terms of what antituberculous drugs to give and when to operate. We found no clinical trials that tackled the length of anti-TB treatment needed. Trials of steroids given with antituberculous drugs suggest possible benefit, but this was not demonstrated conclusively. Open surgical drainage of the fluid accumulating between the heart and the membrane using general anaesthesia was associated with less life threatening re-accummulation of fluid (cardiac tamponade), but with more deaths, but conclusions are not possible as the numbers of patients studied was too small.
The Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD000526. DOI: 10.1002/14651858.CD000526.