Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Primary Purulent Pericarditis with Cardiac Tamponade due to Oropharyngeal Polymicrobial Infection: A Case Report and Literature Review

  • Bhatarai, Mukul (Department of Internal Medicine, Geisinger Medical Center) ;
  • Yost, Gregory (Department of Cardiology, Geisinger Medical Center) ;
  • Good, Christopher W. (Department of Cardiology, Geisinger Medical Center) ;
  • White, Charles F. (Department of Oncology, Geisinger Medical Center) ;
  • Nepal, Hitekshya (Woodside Family Health Center)
  • Received : 2013.09.10
  • Accepted : 2013.11.21
  • Published : 2014.04.05
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Abstract

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy.

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References

  1. Maisch B, Seferovic PM, Ristic AD, et al. Guidelines on the diagnosis and management of pericardial diseases executive summary: The Task force on the diagnosis and management of pericardial diseases of the European society of cardio logy. Eur Heart J 2004;25:587-610. https://doi.org/10.1016/j.ehj.2004.02.002
  2. Parikh SV, Memon N, Echols M, Shah J, McGuire DK, Keeley EC. Purulent pericarditis: report of 2 cases and review of the literature. Medicine (Baltimore) 2009;88:52-65. https://doi.org/10.1097/MD.0b013e318194432b
  3. Sagrista-Sauleda J, Merce AS, Soler-Soler J. Diagnosis and management of pericardial effusion. World J Cardiol 2011;3:135-43. https://doi.org/10.4330/wjc.v3.i5.135
  4. Imazio M, Cecchi E, Demichelis B, et al. Indicators of poor prognosis of acute pericarditis. Circulation 2007;115:2739-44. https://doi.org/10.1161/CIRCULATIONAHA.106.662114
  5. Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet 2004;363:717-27. https://doi.org/10.1016/S0140-6736(04)15648-1
  6. Brook I. Pericarditis due to anaerobic bacteria. Cardiology 2002;97:55-8. https://doi.org/10.1159/000057672
  7. Finegold SM. Anaerobic gram-negative bacilli. In: Baron S, editor. Medical microbiology. 4th ed. Galveston (TX): University of Texas Medical Branch at Galveston; 1996.
  8. Al-Charrakh AH, Al-Khafaji JK, Al-Rubaye RH. Prevalence of β -hemolytic groups C and F streptococci in patients with acute pharyngitis. N Am J Med Sci 2011;3:129-36.
  9. Sawaya FJ, Sawaya JI, Gharzuddine W, Eid EV, Kanj SS. Cardiac tamponade caused by polymicrobial gram-negative organisms. Int J Infect Dis 2009;13:e483-4. https://doi.org/10.1016/j.ijid.2009.01.019
  10. Augustin P, Desmard M, Mordant P, et al. Clinical review: intrapericardial fibrinolysis in management of purulent pericarditis. Crit Care 2011;15:220. https://doi.org/10.1186/cc10022

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