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Purulent pericarditis in childhood: ten years of experience
Omer Cakir1, Fuat Gurkan, Akin Eraslan Balci
1Department of Thoracic and Cardiovascular Surgery, in Dicle University, School of Medicine, Diyarbakir, Turkey.
Insights
Purulent pericarditis, a serious infection of the heart sac, can be effectively managed with surgical drainage and pericardiectomy. Early diagnosis using imaging and pericardiosynthesis improves outcomes in children.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Thoracic Surgery
Background:
- Purulent pericarditis is a life-threatening condition if not treated promptly.
- This study reviews the diagnosis and management of 18 pediatric cases over a decade.
Purpose of the Study:
- To describe the experience with diagnosing and managing purulent pericarditis in children.
- To evaluate the effectiveness of different treatment modalities.
Main Methods:
- Retrospective analysis of 18 children (10 boys, 8 girls; mean age 4 years) treated between 1990 and 2000.
- Diagnosis relied on clinical findings, chest radiography, echocardiography, and pericardiosynthesis.
- Treatment included subxiphoid tube drainage, pericardiectomy, and pericardiocentesis with thrombolysis.
Main Results:
- Fever and cardiac tamponade were the most frequent presentations.
- Staphylococcus aureus was the predominant pathogen; respiratory tract infection was the most common predisposing factor.
- Mortality was low (5.5%), with only one critically ill patient dying.
Conclusions:
- Subxiphoid tube drainage and pericardiectomy yielded good outcomes.
- Intrapericardial streptokinase and pericardial aspiration were also considered beneficial treatment options.
Background/Purpose:
Purulent pericarditis is a rapidly fatal disease if left untreated. This article describes our experience with diagnosis and management of 18 patients seen over a 10-year period.
Methods:
Eighteen children with purulent pericarditis were treated in our clinics between 1990 and 2000. Ten patients were boys and 8 were girls, and the mean age of all patients was 4 years (range, 8 months to 12 years).
Results:
Most common findings were fever and cardiac tamponade. Staphylococcus aureus was the most common causative agent, and the most common predisposing factor was respiratory tract infection. Chest radiography and echocardiography were the most important methods for diagnosis, and pericardiosynthesis was diagnostic in purulent pericarditis. The treatment methods performed in our patients were subxiphoidal pericardial tube (10 patients), pericardiectomy after subxiphoidal pericardial tube (2 patients), pericardiectomy (3 patients), and pericardiocentesis-intrapericardial thrombolytic treatment (3 patients). Only one patient (5.5%) died who was critically ill at the time of admission.
Conclusions:
Subxiphoidal tube drainage and pericardiectomy were performed with good results in these cases. Intrapericardial streptokinase and pericardial aspiration method also was thought to be beneficial.