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[Two cases of pneumococcal pericarditis]
J Svendsen1, V Ormaasen, E von der Lippe
1Medisinsk overvåkning, Ullevål sykehus 0407 Oslo.
Background:
Bacterial pericarditis is often overlooked, partly because symptoms and signs associated with pericarditis are frequently missing, but also because of the rarity of the disease.
Material And Methods:
Two cases of pneumococcal pericarditis treated at Ullevaal University Hospital are presented.
Results:
Pneumococcal pericarditis is a rare, but serious complication to infections like pneumonia, pleural empyema, and septicaemia. Patients with an infectious disease who develop signs of elevated central venous pressure, enlarged cardiac silhouette on chest x-ray, or severe hypotension should have an echocardiography performed. If pericardial fluid is present, a diagnostic pericardiocentesis should be considered.
Interpretation:
Treatment consists of drainage and antibiotics. Pericardiocentesis and subxiphoid catheter drains may be inadequate because of fibrin precipitation resulting in organization of the fluid. In these cases surgical intervention has traditionally been recommended, but intrapericardial fibrinolysis could be an alternative.
Insights
Pneumococcal pericarditis is a rare but serious infection. Early echocardiography and pericardiocentesis are crucial for diagnosis and treatment of this bacterial pericarditis.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Bacterial pericarditis is frequently overlooked due to subtle symptoms and its rarity.
- Pneumococcal pericarditis is a serious complication of infections like pneumonia and sepsis.
Observation:
- Two cases of pneumococcal pericarditis were treated at Ullevaal University Hospital.
- Patients with infectious diseases presenting with elevated central venous pressure, enlarged cardiac silhouette, or hypotension require echocardiography.
Findings:
- Echocardiography is vital for diagnosing pericardial effusion in at-risk patients.
- Diagnostic pericardiocentesis should be considered for pericardial fluid analysis.
Implications:
- Standard treatment involves drainage and antibiotics.
- Intrapericardial fibrinolysis may be an alternative to surgery for complex cases with fibrin precipitation.