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Purulent pericarditis after transbronchial biopsy
Ara Tachjian1, Keri M Shafer2, Claudia Denkinger1
1Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
The Canadian Journal of Cardiology
|August 21, 2014
Summary
A rare case of purulent pericarditis, a serious infection of the sac around the heart, was successfully treated. Prompt diagnosis and surgical intervention led to a full recovery for the patient.
Area of Science:
- Infectious Diseases
- Cardiology
- Pulmonology
Background:
- A 28-year-old woman presented with hypotension and unresponsiveness.
- She had a history of bronchoscopy with needle biopsy for suspected sarcoidosis.
- Initial investigations revealed leukocytosis and acute kidney injury.
Observation:
- Echocardiography identified a large pericardial effusion.
- Pericardiocentesis yielded purulent material.
- Microbiological analysis detected Streptococcus milleri, Prevotella, Veillonella, and Peptostreptococcus species.
Findings:
- The patient was diagnosed with purulent pericarditis.
- Surgical management included pericardiectomy and mediastinal washout.
- The patient experienced rapid clinical improvement post-intervention.
Implications:
- This case highlights the importance of considering infectious etiologies, including purulent pericarditis, in patients with unexplained hypotension and pericardial effusion.
- Aggressive surgical management combined with appropriate antimicrobial therapy can lead to favorable outcomes.
- Early diagnosis and intervention are crucial for managing this life-threatening condition.
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