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Purulent pericarditis as a complication of bacteraemic Enterococcus faecalis urinary tract infection

Fredy Nehme1, Jane Gitau1, Jing Liu2

  • 1Department of Internal Medicine, Kansas University School of Medicine-Wichita, Wichita, Kansas, USA.

BMJ Case Reports
|March 17, 2017
PubMed

Insights

Purulent pericarditis is rare, but this case highlights Enterococcus faecalis from a urinary tract infection. Prompt diagnosis and drainage are crucial for positive outcomes in this serious condition.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Internal Medicine

Background:

  • Purulent pericarditis is a rare condition in the antibiotic era.
  • Commonly arises from pulmonary infections caused by Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae.

Observation:

  • A 69-year-old man presented with purulent pericarditis.
  • The causative agent was identified as Enterococcus faecalis, likely from a urinary tract source via hematogenous spread.
  • Urgent pericardiocentesis was performed, restoring hemodynamic stability.

Findings:

  • The patient received a 4-week course of susceptible antibiotics.
  • Follow-up echocardiography at 3 weeks showed complete resolution of the pericardial effusion.
  • This is the first reported case of purulent pericarditis caused by Enterococcus faecalis originating from a urinary tract source.

Implications:

  • This case underscores the importance of considering Enterococcus faecalis from urinary sources in purulent pericarditis.
  • Prompt diagnosis, pericardiocentesis, and appropriate antibiotic therapy are vital for successful management.
  • Highlights the need for vigilance in identifying non-traditional pathogens in rare infections.

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