What is the rationale for using corticosteroids in TB pericarditis?

• A. Reduce inflammation, relieve symptoms, and prevent fluid accumulation
• B. Cure TB infection
• C. Increase immune suppression
• D. Delay therapy

Answer: (A)

TB pericarditis often comes with intense inflammation of the pericardium, which drives fluid buildup and can lead to scarring that stiffens the heart. Corticosteroids are used to dampen that inflammatory response. By reducing inflammatory mediators, they decrease capillary leak, limit exudate formation, and lessen the amount of pericardial fluid and fibrin deposition. This helps relieve chest pain and dyspnea, speeds improvement of the effusion, lowers the risk of tamponade, and reduces the chance of progressing to constrictive pericarditis. It’s important to remember that steroids are an adjunct to antitubercular therapy and do not cure the TB infection by themselves. They’re chosen for their ability to minimize inflammatory damage and its consequences.