Purulent pericarditis caused by Haemophilus parainfluenzae
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Published on: April 7, 2015
Yevgeniy Latyshev1, Aswin Mathew1, Jeffrey M Jacobson1
1Department of Internal Medicine, Divisions of Cardiovascular Diseases (Drs. Latyshev, Mathew, and Sturm) and Infectious Diseases (Dr. Jacobson), Drexel University College of Medicine, Philadelphia, Pennsylvania 19102.
Abstract:
Bacterial pericarditis is a rare disease in the era of antibiotics. Purulent pericarditis is most often caused by Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae. The number of H. parainfluenzae infections has been increasing; in rare cases, it has caused endocarditis. We report a case of purulent pericarditis caused by H. parainfluenzae in a 62-year-old woman who reported a recent upper respiratory tract infection. The patient presented with signs and symptoms of pericardial tamponade. Urgent pericardiocentesis restored her hemodynamic stability. However, within 24 hours, fluid reaccumulation led to recurrent pericardial tamponade and necessitated the creation of a pericardial window. Cultures of the first pericardial fluid grew H. parainfluenzae. Levofloxacin therapy was started, and the patient recovered. Haemophilus parainfluenzae should be considered in a patient who has signs and symptoms of purulent pericarditis. Prompt diagnosis, treatment, and antibiotic therapy are necessary for the patient's survival. To our knowledge, this is the first report of purulent pericarditis caused by H. parainfluenzae.
Insights
Purulent pericarditis is rare but can be caused by Haemophilus parainfluenzae. This case highlights the importance of considering this pathogen in patients with pericardial tamponade, leading to successful antibiotic treatment.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Bacterial pericarditis is uncommon in the antibiotic era.
- Common causes include Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae.
- An increasing trend of Haemophilus parainfluenzae infections, including rare endocarditis cases, has been noted.
Observation:
- A 62-year-old woman presented with symptoms of pericardial tamponade following an upper respiratory tract infection.
- Initial pericardiocentesis provided temporary hemodynamic stability.
- Recurrent pericardial tamponade necessitated a pericardial window creation within 24 hours.
Findings:
- Cultures of pericardial fluid identified Haemophilus parainfluenzae as the causative agent.
- The patient received Levofloxacin therapy.
- The patient recovered following appropriate antibiotic treatment.
Implications:
- Haemophilus parainfluenzae should be considered in the differential diagnosis of purulent pericarditis.
- Prompt diagnosis and targeted antibiotic therapy are crucial for patient survival.
- This case represents the first reported instance of purulent pericarditis caused by H. parainfluenzae.
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