1/33. Purulent pericarditis with tamponade in a postpartum patient due to group F streptococcus.Bacterial pericarditis with cardiac tamponade is a life-threatening disorder that has been associated with a variety of organisms. There is usually an associated underlying condition or a seeding of the pericardium from an infection elsewhere. We report the development of cardiac tamponade and a subsequent pericardial constriction due to group F streptococcus purulent pericarditis. We believe this to be the first report of a postpartum patient with purulent pericarditis.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
2/33. Purulent pericarditis presenting as an extracardiac mass in a patient with untreated diabetes.A 50-year-old man with symptoms of bi-ventricular heart failure was transferred to our hospital with a diagnosis of extracardiac tumor. He had a 10 year history of untreated diabetes. Chest computed tomography (CT) revealed an extracardiac mass in the right atrio-ventricular groove. cardiac catheterization revealed an elevated mean right atrial pressure of 18 mmHg, mean pulmonary wedge pressure of 16 mmHg, and the right ventricular pressure curve demonstrated typical dips and plateaus. At surgery, there was severe adhesion between the pericardium and epicardium, and the pericardium was severely thickened and contained turbid pus. In the left thoracic cavity, there was large amount of pleural effusion and pus. Therefore, the patient was diagnosed with purulent pericarditis caused by left empyema. The thickened pericardium at the anterior portion of the heart was resected, however resection of the remaining portion was abandoned because the adhesion was so tight. After surgery, the patient underwent irrigation of the heart and left thoracic cavity by 1% povidone iodine solution and 0.5 mg/ml of imipenem for 7 days. Bacteriologic culture of the pus from the pericardium revealed anaerobic gram negative bacteria. After 4 months of antibiotics infusion, his C reactive protein became negative and the patient was subsequently discharged from our hospital.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
3/33. bacteroides pericardial effusion and cardiac tamponade in a patient with chronic renal failure.A 31-year-old woman with chronic renal insufficiency and recurrent pericarditis developed an enlarging cardiac silhouette and physical signs of cardiac tamponade. cardiac catheterization demonstrated pericardial effusion with hemodynamic evidence of cardiac compression. At pericardial exploration, 1.5 L. of foul-smelling purulent material was removed from a distended pericardial sac. Cultures of both the exudate and pericardium revealed pure growth of bacteroides fragiles. The patient was subsequently treated with intravenous chloramphenicol and has had an uncomplicated clinical course since that time. This represents the first reported case of cardiac tamponade secondary to culturally proved bacteroides pericarditis in the setting of chronic renal insufficiency.- - - - - - - - - - ranking = 0.28571428571429keywords = pericarditis (Clic here for more details about this article) |
4/33. delayed diagnosis of purulent pericarditis caused by esophagopericardial fistula by computed tomography scan and echocardiography.We report a case of esophagopericardial fistula with subsequent purulent pericarditis that was diagnosed with computed tomography and echocardiography. In a patient with non-specific chest pain and vague past history, serial echocardiography demonstrated rapid aggravation of pyopneumopericardium and chest CT scan showed a foreign body that caused the fistula in the esophageal wall. Removal of a piece of fish bone, closure of the fistula, and creation of a pericardial window for continuous drainage were performed through a low lateral thoracotomy.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
5/33. Purulent pneumococcal pericarditis: a rarity in the antibiotic era.PURPOSE: The purpose of this report is to show that even while properly treated, pneumococcal disease may proceed to a life-threatening condition including purulent pericarditis and multiple organ failure. patients AND methods: This is a case-report describing one patient treated in the intensive care unit (ICU) of Helsinki University Central Hospital in March 2001. CONCLUSIONS: In the antibiotic era, purulent pericarditis is an extremely rare yet possible condition complicating pneumococcal disease. Because of the growing incidence of penicillin resistance of this community-acquired pathogen, purulent pericarditis may become more common. Early detection and treatment of this otherwise fatal condition may lead to a good outcome.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
6/33. Esophageal-pericardial fistula with purulent pericarditis secondary to esophageal carcinoma presenting with tamponade.A case of esophago-pericardial fistula secondary to esophageal carcinoma causing pericardial effusion and tamponade is presented. Palliation can be achieved effectively by limited thoracotomy, pericardial resection and drainage, and in selected cases esophageal stenting.- - - - - - - - - - ranking = 0.57142857142857keywords = pericarditis (Clic here for more details about this article) |
7/33. Pericardial infusion of tissue plasminogen activator in fibropurulent pericarditis.A 61-year-old man developed a loculated fibropurulent pericarditis, a rare complication of bacteremia. This occurred as a complication of a Staphylococcal aureus bacteremia from a head and neck abscess following self-extraction of a tooth. Despite surgical intervention and placement of 2 pericardial drains, a refractory, inadequately drained infected pericardial effusion persisted. Although there is limited experience with thrombolytic therapy to dissolve a fibrin clot in the pericardium, break down loculated adhesions, and facilitate free drainage of infected material, lysis is well described in the management of exudative pleural effusions. After infusion of 30 mg of tissue plasminogen activator in 100 cc normal saline through the pericardial drain of the patient, a large amount of infected serosanginous material subsequently drained during the next 2 days. The patient became afebrile and culture negative, remained hemodynamically stable, and had resolution of his pericarditis and pericardial effusion on electrocardiogram and echocardiogram, respectively.- - - - - - - - - - ranking = 0.85714285714286keywords = pericarditis (Clic here for more details about this article) |
8/33. Effectiveness of intrapericardial administration of streptokinase in purulent pericarditis.BACKGROUND AND PURPOSE: Purulent pericarditis is very rare. However, among patients suffering from this disease the mortality rate is very high. The aim of this study was to evaluate the effectiveness and side effects of intrapericardial streptokinase administration in patients with confirmed purulent pericarditis. patients AND methods: Three patients, one 50-year-old man and two women aged 64 and 40 years, who were admitted to the intensive care unit (ICU) due to purulent pericarditis, entered the study. In all three cases a subxiphoid pericardiotomy followed by insertion of a drainage line into the pericardial space was performed. Antibiotic therapy was started immediately on admission to the hospital. Despite continued antibiotic therapy in all three patients, daily drainage from the pericardium--during several days after surgery--staggered between 50-200 ml/day. Due to considerable purulent pericardial drainage loculations and/or fibrin deposits confirmed by echocardiography, streptokinase (500,000 IU dissolved in 50 ml of normal saline) was administered into the pericardial space over 10 min, using the previously inserted drainage catheter. This regimen was repeated after 12 and 24 h. The total dose of streptokinase was 1,500,000 IU. RESULTS: The clinical effect of intrapericardial streptokinase administration was excellent. Several days after intrapericardial administration of streptokinase, drainage of purulent pericardial fluid stopped. No complications associated with intrapericardial streptokinase administration were observed. In the follow-up echocardiography (in two patients repeated 6 and 9 months after delivery of streptokinase), pericardial fluid and echocardiographic signs of pericardial constriction were not observed. CONCLUSION: Intrapericardial administration of streptokinase in purulent pericarditis is effective and safe.- - - - - - - - - - ranking = 1.1428571428571keywords = pericarditis (Clic here for more details about this article) |
9/33. A preventable illness? Purulent pericarditis due to streptococcus pneumoniae complicated by haemolytic uraemic syndrome in an infant.A previously healthy eight-month-old infant presented with shortness of breath and pyrexia. He was found to have purulent pericarditis due to streptococcus pneumoniae, complicated by acute renal failure due to haemolytic uraemic syndrome. He received peritoneal dialysis and recovered with normalisation of renal function. This case highlights two important complications of pneumococcal infection in one individual and illustrates the need for rapid diagnosis and treatment of invasive pneumococcal disease. It is anticipated that introduction of the conjugate pneumococcal vaccination to the Australian Standard vaccination Schedule from 2005 will reduce the incidence of pneumococcal infection and its associated morbidity and mortality.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
10/33. Infective endocarditis and acute purulent pericarditis in a patient with hyperglycemia.A diabetic patient was admitted to our hospital for infective endocarditis with acute purulent pericarditis and diabetic ketoacidosis. echocardiography revealed attachment of vegetation to the chordae tendineae in the left ventricle and pericaridial effusion. The vegetation was enlarged and pendulated for a few days despite maximal antimicrobial therapy. Surgical resection was desirable to decrease the risk of embolic complications and cardiovascular collapse. We could not open the heart because of accumulation of purulent pericardial fluid, and right renal infarction was complicated. We believe that the immunocompromised and hypercoagulable state due to diabetes caused these conditions.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
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