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Purulent pericarditis caused by Streptococcus milleri.

K Akashi1, T Ishimaru, Y Tsuda

  • 1First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Japan.

Archives of Internal Medicine
|November 1, 1988
PubMed
Summary

Streptococcus milleri, a bacterium, was identified in the pericardial fluid of a patient with pulmonary tuberculosis. Surgical pericardiectomy was necessary to resolve the resulting pericarditis.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Pulmonary tuberculosis (TB) can present with extrapulmonary manifestations.
  • Pericarditis is an inflammation of the pericardium, the sac surrounding the heart.
  • Tuberculous pericarditis is a significant cause of morbidity and mortality, particularly in endemic areas.

Observation:

  • A 42-year-old male patient presented with symptoms suggestive of pericarditis.
  • Diagnostic investigations revealed the presence of Streptococcus milleri in the pericardial fluid.
  • The patient had a concurrent diagnosis of pulmonary tuberculosis.

Findings:

  • Pure culture isolation of Streptococcus milleri from pericardial fluid confirmed a bacterial etiology.
  • The pericarditis was directly linked to the Streptococcus milleri infection.

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  • Pulmonary tuberculosis was identified as a co-existing condition.

    • Implications:

    • This case highlights the potential for Streptococcus milleri to cause severe pericarditis, even in the context of pulmonary tuberculosis.
    • Aggressive management, including surgical intervention like pericardiectomy, may be crucial for treatment success.
    • Further research into the pathogenesis and optimal treatment strategies for mixed infections involving Streptococcus milleri and tuberculosis is warranted.