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Subacute Polymicrobial Bacterial Pericarditis Mimicking Tuberculous Pericarditis: A Case Report
Anna E Carmack1, Allison M LaRocco1, Minu Mathew2
1Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
The American Journal of Case Reports
|November 16, 2021
Summary
Bacterial pericarditis diagnosis is challenging. A case highlights the need for tissue biopsy to identify bacteria like Prevotella oris and Fusobacterium nucleatum, avoiding misdiagnosis of tuberculosis pericarditis.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Bacterial pericarditis diagnosis is often difficult due to challenges in obtaining tissue for bacterial identification.
- Tuberculosis pericarditis is frequently suspected, potentially leading to delayed or incorrect diagnosis and treatment.
Observation:
- A 34-year-old man presented with symptoms suggestive of pericarditis, initially treated for presumed tuberculosis pericarditis without tissue diagnosis.
- The patient's condition worsened, revealing polymicrobial bacterial pericarditis (Prevotella oris and Fusobacterium nucleatum) after a pericardial biopsy.
Findings:
- Tissue culture and sequence-based analysis are crucial for accurate identification of causative bacteria in pericarditis.
- Polymicrobial infections can occur in bacterial pericarditis, necessitating broad-spectrum diagnostic approaches.
Implications:
- Emphasizes the importance of pursuing tissue biopsy for definitive diagnosis in suspected bacterial pericarditis, especially in resource-rich settings.
- Highlights the need to consider bacterial causes alongside tuberculosis, and to avoid diagnostic anchoring.
- Timely and accurate diagnosis through appropriate methods like sequence-based analysis can prevent disease progression and inappropriate therapies.
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