Immunotherapy for Tuberculous Pericarditis

Pericardial tuberculosis is an important clinical problem in resource-limited countries, particularly in those with concomitant epidemics of human immunodeficiency virus (HIV) infection. Tuberculosis involving closed anatomical spaces such as the pericardium or meninges can cause devastating inflammatory injury, and management with antimicrobial therapy alone may not prevent complications. Host-directed therapies that attenuate destructive inflammatory responses may prevent serious sequelae. Current American and World Health Organization guidelines strongly recommend treatment with glucocorticoids in addition to antituberculosis drugs in patients with tuberculous pericarditis, but expert European guidelines are more muted, reflecting the uncertainty of the evidence.13 Mayosi and colleagues now report . . .