HIV induced pericarditis differential diagnosis
HIV pericarditis must be differentiated based on existence of pericarditis and reason of pericarditis, so the below is the differential according to these two different basis.
Differentiating HIV induced pericarditis from other Diseases
- HIV induced pericarditis usually remains sillent and is found during autopsies as a random co-existing condition.
- If it was symptomatic, we can differentiate underlying cause as below:
|Diseases||Clinical manifestations||Para-clinical findings||Gold standard|
|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|
Differential diagnosis of pericarditis
Chest pain or pressure are common symptoms. A small effusion may be asymptomatic. Larger effusions may cause cardiac tamponade, a life-threatening complication and the signs of impending tamponade include dyspnea, low blood pressure, and distant heart sounds. There are several other cardiac insults with similar symptoms that should be considered in differential diagnosis of pericardial effusion.
Differential Diagnosis by Organ System
- Scarlett JA, Kistner ML, Yang LC (1979). "Behçet's syndrome. Report of a case associated with pericardial effusion and cryoglobulinemia treated with indomethacin". Am J Med. 66 (1): 146–8. PMID 420242.
- Garewal HS, Uhlmann RF, Bennett RM (1981). "Pericardial effusion in association with giant cell arteritis". West J Med. 134 (1): 71–2. PMC 1272467. PMID 7210667.
- Wilson J, Zaman AG, Simmons AV (1990). "Gonococcal arthritis complicated by acute pericarditis and pericardial effusion". Br Heart J. 63 (2): 134–5. PMC 1024342. PMID 2317408.