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Diagnosis of pneumococcal pericarditis using antigen testing and polymerase chain reaction

Teresa Inkster1, Nitish Khanna, Mathew Diggle

  • 1Department of Microbiology, Golden Jubilee Hospital, Clydebank, Glasgow, Scotland. Teresa.Inkster@nhs.net

Scandinavian Journal of Infectious Diseases
|May 21, 2010
PubMed

Insights

Pneumococcal pericarditis is rare but can occur after pneumonia. Diagnosis in culture-negative cases can be achieved using antigen testing and PCR on pericardial fluid.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Pneumococcal pericarditis, an infection of the sac surrounding the heart caused by Streptococcus pneumoniae, has become uncommon since the introduction of antibiotics.
  • Community-acquired pneumonia is a potential precursor to pneumococcal pericarditis.

Observation:

  • This report details two cases of pneumococcal pericarditis that followed community-acquired pneumonia.
  • Both patients presented with negative bacterial cultures from pericardial fluid.

Findings:

  • Diagnosis was established through antigen testing and polymerase chain reaction (PCR) analysis of pericardial fluid.
  • These molecular and antigen-based methods are crucial for identifying pneumococci in culture-negative effusions.

Implications:

  • Consider PCR or antigen testing for pneumococci in pericardial fluid for patients with suggestive symptoms, especially if cultures are negative or antibiotic history is present.
  • These diagnostic tools improve the detection of rare but serious infections like pneumococcal pericarditis.

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