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Purulent Pericarditis in Sickle Cell Disease Due to Streptococcus agalactiae; a Unique Case Report and Literature

Alina Bhat1, Elvira Neculiseanu1, Eric L Tam1

  • 1a Downstate College of Medicine, Department of Medicine, Division of Hematology-Oncology , State University of New York , Brooklyn , NY , USA.

Hemoglobin
|March 19, 2019
PubMed

Insights

Purulent pericarditis caused by Streptococcus agalactiae is rare in sickle cell disease patients. This case highlights the need for prompt surgical intervention and surgical pericardiocentesis for effective management.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Hematology

Background:

  • Purulent pericarditis, characterized by a thick exudate, historically carries a high mortality rate.
  • Streptococcus agalactiae (S. agalactiae) is an uncommon cause of purulent pericarditis, particularly in patients with underlying conditions like sickle cell disease.

Observation:

  • A 30-year-old woman with sickle cell disease presented with fever, dyspnea, and S. agalactiae septicemia, indicative of a severe infection.
  • Despite prompt antibiotic treatment, she developed a significant purulent pericardial effusion, necessitating surgical intervention.

Findings:

  • The patient underwent surgical pericardiocentesis and a pericardial window procedure for the large purulent pericardial effusion.
  • Literature review revealed only four previously reported cases of purulent pericarditis in sickle cell patients, underscoring the rarity of this presentation.

Implications:

  • This case emphasizes the importance of considering purulent pericarditis in sickle cell patients presenting with sepsis and respiratory symptoms.
  • The successful surgical management highlights its critical role in improving outcomes for this rare and potentially fatal condition.
  • Further research into the pathogenesis of delayed pericardial effusion in purulent pericarditis is warranted.
Keywords:
Purulent pericarditissickle cell disease

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