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Streptococcus anginosus purulent pericarditis with cardiac tamponade after coronary artery bypass surgery

Qiangjun Cai1

  • 1Cardiology, University of Texas Medical Branch at Galveston, Angleton, Texas, USA qiacai@utmb.edu.

BMJ Case Reports
|August 27, 2020
PubMed

Insights

Purulent pericarditis from Streptococcus anginosus is rare. This case highlights sternal wound infection as a potential source following cardiac surgery, successfully treated with antibiotics.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Surgical Infections

Background:

  • Purulent pericarditis is a rare but serious complication.
  • Streptococcus anginosus is an uncommon cause of purulent pericarditis.
  • Post-sternotomy wound complications can lead to deep-seated infections.

Observation:

  • A 66-year-old male developed fever, dyspnea, and presyncope after coronary artery bypass surgery.
  • Complications included sternal wound dehiscence with drainage.
  • Echocardiography revealed a large pericardial effusion causing tamponade.

Findings:

  • Emergent pericardiocentesis yielded Streptococcus anginosus.
  • Intravenous ceftriaxone for 4 weeks resulted in complete clinical recovery.
  • The sternal wound was identified as the likely source of infection.

Implications:

  • This case underscores the importance of vigilant monitoring for deep sternal wound infections post-cardiac surgery.
  • It highlights Streptococcus anginosus as a potential pathogen in post-operative purulent pericarditis.
  • Early recognition and targeted antibiotic therapy are crucial for favorable outcomes.

Keywords:
pericardial diseaseultrasonography

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