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[A case report: suppurative pericardial effusion]
K Zacharowski1, S Kessler, F Bittinger
1William Harvey Research Institute, London, UK. k.zacharowski@mds.qmw.ac.uk
Abstract:
We present the case of a 67 year old woman who was resuscitated due to cardiac tamponade. Examination of the pus fluid showed a bacterial infection with streptococcus milleri. Four days before resuscitation the patient experienced weakness, dyspnoea, increased temperature (39 degrees C), swelling of the neck, and pain on swallowing. Using computed tomography, examination revealed an infection extending from the right tonsil to the mediastinum and into the pericardium. After surgery to remove the retropharyngeal abscess, the patient healed well. Therefore, on presentation of a cardiac tamponade, possible hematogenous or lymphogenous causes or per continuitatem infections should always be considered. In this case the germs in the fluid and the typical patient history indicated an oropharyngeal reason.
Insights
A 67-year-old woman
Area of Science:
- Infectious Diseases
- Cardiology
- Otolaryngology
Background:
- Cardiac tamponade can be a life-threatening condition.
- Oropharyngeal infections can spread to the mediastinum and pericardium.
- Streptococcus milleri is a common bacterium found in the oropharynx.
Observation:
- A 67-year-old woman presented with symptoms of cardiac tamponade.
- She had a history of neck swelling, fever, and pain upon swallowing.
- Computed tomography revealed an infection extending from her tonsil to the mediastinum and pericardium.
Findings:
- Pus fluid analysis identified Streptococcus milleri infection.
- The patient underwent surgery to remove a retropharyngeal abscess.
- She experienced a successful recovery post-surgery.
Implications:
- Cardiac tamponade necessitates consideration of contiguous or hematogenous spread from oropharyngeal infections.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
- This case highlights the importance of a thorough patient history and diagnostic imaging in identifying the source of infection.