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Acute bacterial percarditis in children: report of 25 cases
Insights
Optimal treatment for acute bacterial pericarditis in children involves antibiotics and surgical drainage, significantly improving survival rates. Antibiotic therapy alone is often insufficient, highlighting the need for combined approaches.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Acute bacterial pericarditis is a serious condition in children.
- Mortality rates can be high without appropriate intervention.
Purpose of the Study:
- To review cases of acute bacterial pericarditis in pediatric patients.
- To evaluate the effectiveness of different treatment strategies.
Main Methods:
- Retrospective review of 25 pediatric patients with acute bacterial pericarditis.
- Analysis of presenting symptoms, bacteriology, and treatment responses.
Main Results:
- 52% of patients died overall.
- Combined antibiotic and surgical drainage therapy resulted in a 90% survival rate.
- Antibiotic therapy alone had a lower survival rate (30%).
Conclusions:
- Intravenous antibiotics combined with surgical drainage represent optimal therapy for acute bacterial pericarditis in children.
- Prompt surgical intervention is crucial, especially with significant pericardial effusion.
- Early diagnosis and comprehensive treatment are vital to reduce mortality and prevent complications like constrictive pericarditis.
Abstract:
Twenty-five patients, aged 5 months to 14 years, with acute bacterial pericarditis are reported. Thirteen (52 per cent) of the patients died. The presenting symptoms, associated illness and physical findings, bacteriology, and response to therapy are reviewed. Optimum therapy consists of intravenous administration of specific antibiotics combined with surgical drainage; 90 per cent of our patients treated in this fashion survived. Antibiotic therapy alone is usually inadequate, especially in the presence of significant effusion, and among our patients only three of 10 patients so treated survived. One patient developed constrictive pericarditis 1 month after the initial attack with meningococcal pericarditis and required pericardectomy.