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Purulent pericarditis with quadruple valve endocarditis
Huliyurdurga S Setty Natrajsetty1, Ishwarappa B Vijayalakshmi1, Chitra Narasimhan1
1Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
Background:
Infective endocarditis (IE) is a disease with a highly varied clinical picture. Spread of the infection to the pericardium from the infective endocardium is uncommon and IE involving all 4 cardiac valves is also a very rare occurrence, being more common in intravenous drug users (IVDU).
Case Report:
A 7-year-old boy had purulent pericarditis with infective endocarditis (IE) on all 4 cardiac valves and vegetation in the left ventricular and right atrial cavity. Culture of the pericardial fluid grew methicillin-resistant staphylococcus aureus (MRSA) sensitive to tigecycline. The child made a dramatic improvement with tigecycline treatment.
Conclusions:
Aggressive management with pericardiocentesis and appropriate antibiotics can show remarkable clinical improvement. Tigecycline can be used safely and effectively as a life-saving drug in children.
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