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Bronchomediastinal fistula presenting as purulent pericarditis in a healthy 32-year-old man

Aiman Smer1, Alok Saurav1, Ahmed Abuzaid1

  • 1Creighton University Medical Center, Cardiology Department, Omaha, NE, USA.

Journal of Cardiology Cases
|December 15, 2018
PubMed

Insights

Acute purulent pericarditis, a rare anaerobic bacterial infection, can be fatal if not treated promptly. This case highlights a bronchomediastinal fistula as a complication of lung infection, leading to pericarditis.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Thoracic Surgery

Background:

  • Acute purulent pericarditis is a rare but often fatal condition.
  • Anaerobic bacteria are infrequent causes of purulent pericarditis.
  • Common primary sources include esophagomediastinal fistulas and odontogenic or pleuropulmonary infections.

Observation:

  • A case of bronchomediastinal fistula, a sequela of necrotizing parenchymal infection, is presented.
  • This fistula led to secondary mediastinitis and pleuropericardial involvement.
  • The patient was immunocompetent.

Findings:

  • The study identifies *Eikenella corrodens* as a significant pathogen in intrathoracic suppurative infections.
  • Bronchomediastinal fistula can result in secondary purulent pericarditis.
  • Prompt diagnosis and treatment are crucial for survival.

Implications:

  • Physicians should consider purulent pericarditis in patients with thoracic infections, particularly those with fistulas.
  • *Eikenella corrodens* should be recognized as a potential cause of severe intrathoracic infections.
  • Early recognition and management of purulent pericarditis are critical to prevent fatal outcomes.
Keywords:
AnaerobicFistulaImmunocompetentPericarditis

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