28 February 2020 : Case report
Idiopathic Purulent Pericarditis: A Rare Diagnosis
Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare diseaseArjun Kanwal1BEF*, Dimitrios Avgeropoulos1EF, Jason G. Kaplan2EF, Aditya Saini3E
Am J Case Rep 2020; 21:e921633
BACKGROUND: Acute bacterial pericarditis is rare, and the incidence numbers have been declining in the modern antibiotic era. Purulent bacterial pericarditis is a fatal disease in which mortality rates can reach 100% if left untreated.
CASE REPORT: We present a case of primary purulent bacterial pericarditis with polymicrobial growth including Micromonas micro, Prevotella intermedia and Fusobacterium species, all of which are anaerobic flora of the oral cavity. Constant re-accumulation of the purulent pericardial effusion led the patient to have recurrent echocardiographic and clinical cardiac tamponade requiring recurrent pericardiocentesis’ and eventually a pericardial window.
CONCLUSIONS: Although rare, bacterial pericarditis has been noted to lead to clinical and echocardiographic tamponade. Early diagnosis and treatment are necessary for improving clinical outcomes. It is important to have a suspicion for purulent pericarditis, due to its high level of mortality, in patients who present with non-specific symptoms and pleuritic chest pain.
Keywords: Bacteria, Anaerobic, Cardiac Tamponade, Pericarditis, Anti-Bacterial Agents, Fusobacterium, Pericardiocentesis, Prevotella intermedia, Rare Diseases
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