Methicillin-Resistant Staphylococcus aureus (MRSA)-Positive Pericardial Abscess Presenting in a Hemodialysis Patient

Area of Science:

• Nephrology
• Infectious Diseases
• Cardiology

Background:

• Purulent pericarditis is a rare infection of the pericardial space.
• Dialysis patients with end-stage renal disease (ESRD) are at increased risk due to potential hematogenous spread.
• Uremic pericarditis is a known complication in ESRD patients, sometimes requiring intervention.

Observation:

• A male patient undergoing hemodialysis for ESRD presented with a pericardial abscess.
• The patient had a history of two previous pericardial effusions attributed to uremic pericarditis.
• The abscess was caused by methicillin-resistant Staphylococcus aureus (MRSA) infection.

Findings:

• The case demonstrates a rare presentation of purulent pericarditis as a pericardial abscess.
• Hematogenous spread of MRSA was the identified cause of the infection in this ESRD patient.
• Prior history of uremic pericarditis may be a predisposing factor.

Implications:

• This case underscores the importance of considering uncommon infections in dialysis patients with cardiac symptoms.
• Early diagnosis and appropriate antibiotic treatment are crucial for managing pericardial abscesses, especially those caused by resistant organisms like MRSA.
• Further research into the specific risk factors and optimal management strategies for purulent pericarditis in ESRD patients is warranted.