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A Rare Case of Pyopericardium After Blunt Thoracic Trauma

Gergana Boyadzhieva1, Michael Stickel2, Michael Christ2

  • 1Department of Surgery, Cantonal Hospital of Lucerne, Lucerne, Switzerland.

The Annals of Thoracic Surgery
|September 4, 2020
PubMed

Insights

Purulent pericarditis, a severe infection often caused by Streptococcus pneumoniae, has high mortality. This case highlights a rare delayed presentation after chest trauma, successfully managed with drainage and antibiotics.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Trauma Surgery

Background:

  • Bacterial purulent pericarditis is a life-threatening infection with high mortality rates, especially if untreated.
  • Gram-positive bacteria, particularly Streptococcus pneumoniae, account for 40-50% of these infections.
  • Delayed complications following thoracic trauma can include severe infections.

Observation:

  • A rare case of purulent pericarditis caused by Streptococcus pneumoniae is presented.
  • This infection occurred as a delayed complication following blunt thoracic trauma.
  • The patient presented with symptoms necessitating urgent intervention.

Findings:

  • Successful treatment involved a combination of urgent pericardiocentesis, thoracoscopic pericardial fenestration, and broad-spectrum antibiotics.
  • Prompt medical and surgical intervention was crucial for patient recovery.
  • The case underscores the potential for severe infections as delayed sequelae of trauma.

Implications:

  • A high index of suspicion for purulent pericarditis is essential, particularly in patients with a history of thoracic trauma.
  • Early diagnosis and aggressive management, including drainage and antibiotics, are critical for improving outcomes.
  • This case expands the understanding of Streptococcus pneumoniae pericarditis complications.

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