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Purulent pneumococcal pericarditis, a vaccine-preventable illness
Matthew J Rees1, Andrew Wilson2
1Department of Haematology, The Austin Hospital, Heidelberg, Victoria, Australia.
Oxford Medical Case Reports
|November 28, 2019
Summary
A rare case of purulent pericarditis caused by Streptococcus pneumoniae complicated community-acquired pneumonia highlights the risks of invasive pneumococcal disease (IPD). Adult vaccination against IPD is crucial for preventing severe outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Invasive pneumococcal disease (IPD) can lead to severe complications, including purulent pericarditis.
- Community-acquired pneumonia (CAP) is a common presentation of IPD, but pericardial involvement is rare.
Observation:
- A 74-year-old male presented with acute chest pain, fever, and ST elevation, later developing dyspnea and consolidation.
- Diagnostic imaging revealed a large pericardial effusion and right middle lobe pneumonia.
- Pericardiocentesis yielded purulent fluid positive for pneumococcal antigen.
Findings:
- The patient was diagnosed with purulent pericarditis secondary to pneumococcal CAP.
- Despite treatment, the case underscores the potential lethality of invasive pneumococcal infections.
- Echocardiography showed a large pericardial effusion with thickened pericardium but no tamponade.
Implications:
- This case emphasizes the importance of considering IPD in patients with pneumonia and cardiac symptoms.
- Low adult vaccination rates for pneumococcal disease contribute to preventable morbidity and mortality.
- Opportunistic vaccination of older adults by healthcare professionals is recommended to reduce the burden of IPD.
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