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Purulent pericarditis caused by methicillin-sensitive Staphylococcus aureus bacteriuria.

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Purulent pericarditis (PP) can arise from asymptomatic bacteriuria, even in immunocompetent patients using steroids. Early recognition is crucial for this serious infection, often presenting with atypical symptoms.

Keywords:
Staphylococcus aureus BacteriuriaAsymptomatic bacteriuriaPurulent pericarditis

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Nephrology

Background:

  • Purulent pericarditis (PP) is a serious pericardial infection with high mortality.
  • Typical risk factors include immunosuppression, diabetes, and malignancy.
  • PP often lacks classic signs, necessitating a high index of suspicion.

Observation:

  • An 81-year-old male on high-dose steroids presented with epigastric pain.
  • He had a history of urinary retention and asymptomatic bacteriuria (MSSA).
  • A pericardial effusion was identified, with fluid cultures positive for MSSA.

Findings:

  • The pericardial fluid MSSA strain matched the urine isolate.
  • A diagnosis of purulent pericarditis secondary to asymptomatic bacteriuria was made.
  • This case highlights an atypical presentation of PP in an immunocompetent patient.

Implications:

  • Emphasizes the importance of considering PP in patients with atypical risk factors.
  • Suggests asymptomatic bacteriuria, especially with urinary instrumentation and steroid use, can lead to PP.
  • Underscores the need for early diagnosis and management of PP.