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Acute purulent pericarditis in Omani children
Insights
Purulent pericardial effusions in children are serious but treatable. Early diagnosis using echocardiography and prompt treatment with antibiotics and drainage can prevent severe outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Purulent pericardial effusion is a rare but severe condition in children.
- It is associated with significant morbidity and mortality, especially in developing countries.
Purpose of the Study:
- To analyze cases of purulent pericardial effusion in children at a tertiary care hospital.
- To identify common causative organisms and evaluate the effectiveness of diagnostic and treatment strategies.
Main Methods:
- Retrospective analysis of eight pediatric cases with purulent pericardial effusion.
- Review of clinical data, blood and pericardial fluid cultures, and echocardiography findings.
- Assessment of treatment outcomes including surgical drainage and antibiotic therapy.
Main Results:
- Six of eight patients were under two years of age.
- Common pathogens included Haemophilus influenzae, Streptococcus pneumoniae, E. coli, and Streptococcus viridans.
- Early diagnosis via echocardiography and prompt surgical drainage with antibiotics led to favorable outcomes.
Conclusions:
- Purulent pericardial effusion in children requires prompt diagnosis and aggressive management.
- Echocardiography is crucial for early diagnosis.
- Effective treatment involves surgical drainage and broad-spectrum antibiotics, significantly reducing mortality.
Abstract:
A total of eight children admitted to the Royal Hospital, Muscat with purulent pericardial effusions were analysed. Six of the cases were in children less than 2 years of age. Five of the eight children had positive blood cultures: Haemophilus influenzae was cultured from two patients, Streptococcus pneumoniae from one patient, E. coli from one patient and Streptococcus viridans from the remaining child. In three children both blood and pericardial cultures were sterile; two of these children had received prior antibiotics. In our experience early diagnosis by cross-sectional echocardiography followed by adequate surgical drainage and parenteral administration of broad spectrum antibiotics helped prevent the high morbidity and mortality usually reported in this condition in developing countries.