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Primary (isolated) meningococcal pericarditis.

David R Morgan1, Mark Spence, Mary Crowe

  • 1Department of Cardiology, Belfast City Hospital, Northern Ireland, UK.

Clinical Cardiology
|June 13, 2002
PubMed
Summary
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A rare case of bacterial pericarditis caused by Neisseria meningitidis Group C in a young adult was successfully treated with cefotaxime after initial benzylpenicillin failure. This highlights a good prognosis for isolated meningococcal pericarditis.

Area of Science:

  • Infectious Diseases
  • Cardiology

Background:

  • Bacterial pericarditis is a serious condition requiring prompt diagnosis and treatment.
  • Neisseria meningitidis, a common cause of meningitis, can rarely manifest as isolated pericarditis.

Observation:

  • A 19-year-old male presented with symptoms suggestive of bacterial pericarditis.
  • Blood cultures identified Neisseria meningitidis Group C, susceptible to penicillin.
  • Initial treatment with intravenous benzylpenicillin and pericardial instillation failed to resolve the condition.

Findings:

  • Substitution of benzylpenicillin with cefotaxime led to rapid clinical improvement.
  • Echocardiography confirmed resolution of pericardial effusion and no signs of constrictive pericarditis.
  • Primary meningococcal pericarditis, though rare, is a recognized entity with a favorable outcome.

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Implications:

  • Cefotaxime may be a crucial alternative antibiotic in refractory meningococcal pericarditis.
  • Early recognition and appropriate management are key for favorable outcomes in meningococcal pericarditis.
  • This case underscores the importance of considering diverse presentations of Neisseria meningitidis infections.