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23 April 2015 : Case report  India

Purulent Pericarditis with Quadruple Valve Endocarditis

Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Huliyurdurga S. Setty NatrajsettyABEF, Ishwarappa B. VijayalakshmiA, Chitra NarasimhanF, Cholenahalli N. ManjunathAF

DOI: 10.12659/AJCR.893072

Am J Case Rep 2015; 16:236-239

Abstract

BACKGROUND: Infective endocarditis (IE) is a disease with a highly varied clinical picture. Spread of the infection to the pericardium from the infective endocardium is uncommon and IE involving all 4 cardiac valves is also a very rare occurrence, being more common in intravenous drug users (IVDU).

CASE REPORT: A 7-year-old boy had purulent pericarditis with infective endocarditis (IE) on all 4 cardiac valves and vegetation in the left ventricular and right atrial cavity. Culture of the pericardial fluid grew methicillin-resistant staphylococcus aureus (MRSA) sensitive to tigecycline. The child made a dramatic improvement with tigecycline treatment.

CONCLUSIONS: Aggressive management with pericardiocentesis and appropriate antibiotics can show remarkable clinical improvement. Tigecycline can be used safely and effectively as a life-saving drug in children.

Keywords: Anti-Bacterial Agents - therapeutic use, Child, Diagnosis, Differential, Echocardiography, Endocarditis, Bacterial - ultrasonography, Heart Valve Diseases - ultrasonography, Methicillin-Resistant Staphylococcus aureus - isolation & purification, Pericardiocentesis, Pericarditis - ultrasonography, Staphylococcal Infections - ultrasonography

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923