Tuberculous Pericarditis-Reply

Noble O. Fowler, MD
JAMA. 1992;267(7):932. doi:10.1001/jama.1992.03480070047019.
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In Reply.  —I wish to thank Dr Dalvi for his comments concerning our article on tuberculous pericarditis. Dalvi is correct in stating that our description of tuberculous pericarditis is primarily based on reports from industrialized countries. However, our article also relates experiences with this disease in Transkei, South Africa,1,2 where, as in India, tuberculosis is the leading cause of pericarditis. This is unlike the prevalence in Spain, where only 4% of instances of acute pericarditis are due to tuberculosis.3 The Indian experience also differs from that in the West with regard to constrictive pericarditis. In a recent report of 118 cases of constrictive pericarditis in India, tuberculosis was the cause in 72.4 On the other hand, in a report of 95 cases from Stanford University in the United States, no instance of constrictive pericarditis was attributed to tuberculosis.5Among other diagnostic difficulties, Dalvi comments on


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