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Bacterial pericarditis: diagnosis and management.

Sabine Pankuweit1, Arsen D Ristić, Petar M Seferović

  • 1Department of Internal Medicine - Cardiology, Philipps University, Marburg, Germany.

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|February 24, 2005
PubMed
Summary

Bacterial pericarditis, especially purulent forms, is a severe infection requiring urgent drainage and antibiotics. Tuberculous pericarditis also has high mortality without prompt treatment and specific drug regimens.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Internal Medicine

Background:

  • Bacterial pericarditis arises from direct infection, contiguous spread, or hematogenous dissemination.
  • Common bacterial culprits include Staphylococcus, Streptococcus, Haemophilus, and Mycobacterium tuberculosis.
  • AIDS patients exhibit a higher incidence of bacterial pericarditis, notably Mycobacterium avium-intracellulare.

Purpose of the Study:

  • To outline the causes, clinical manifestations, and management strategies for bacterial and tuberculous pericarditis.
  • To emphasize the critical nature of purulent pericarditis and its treatment imperatives.
  • To detail therapeutic approaches for both purulent and tuberculous pericarditis, including antimicrobial and corticosteroid use.

Main Methods:

  • Review of literature on bacterial and tuberculous pericarditis pathogenesis and clinical presentation.

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  • Description of diagnostic considerations and treatment protocols.
  • Emphasis on urgent pericardial drainage and appropriate antimicrobial/antitubercular therapy.

    • Main Results:

    • Purulent pericarditis is a fulminant illness with high mortality (40% even with treatment), often due to cardiac tamponade or decompensation.
    • Tuberculous pericarditis presents variedly and has an 85% mortality rate if untreated.
    • Effective management involves prompt drainage and targeted antimicrobial or antitubercular drug regimens.

    Conclusions:

    • Bacterial and tuberculous pericarditis are serious conditions necessitating rapid diagnosis and intervention.
    • Urgent pericardial drainage combined with appropriate intravenous antibiotics is crucial for purulent pericarditis.
    • Tuberculous pericarditis requires a specific multi-drug regimen and corticosteroids, with surgery reserved for refractory cases.