A case of effusive constrictive pericarditis caused by Streptococcus milleri

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Published on: April 7, 2015

K Hirata1, H Asato, M Maeshiro

  • 1Division of Cardiology, Okinawa Chuba Hospital, Japan.

Japanese Circulation Journal
|February 1, 1991
PubMed

Insights

A rare Streptococcus milleri infection caused effusive-constrictive pericarditis, a condition mimicking tuberculosis or tumors. Surgical pericardium removal was necessary after pericardiocentesis failed to restore normal heart function.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • Effusive-constrictive pericarditis presents with impaired ventricular filling and hemodynamic compromise.
  • Diagnosis can be challenging, often mimicking other serious conditions like tuberculosis or malignancy.
  • Identifying the underlying etiology is crucial for effective treatment.

Observation:

  • A 55-year-old male exhibited hypotension and elevated jugular venous pressure.
  • Echocardiography revealed pericardial effusion with dense, shaggy fibrinous strands.
  • Pericardiocentesis did not resolve the impaired ventricular filling or low cardiac output.

Findings:

  • Hemodynamic evaluation post-pericardiocentesis showed persistent equalization of pressures and low cardiac output.
  • Surgical pericardiectomy was ultimately required.
  • Infectious etiology identified as Streptococcus milleri, despite initial suspicion of tuberculosis or tumor.

Implications:

  • This case highlights Streptococcus milleri as a rare cause of effusive-constrictive pericarditis.
  • It underscores the importance of considering infectious etiologies even with atypical presentations.
  • Effective management may require both pericardiocentesis and surgical intervention.

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