Case Report: Pericardial effusion in late onset neonatal Escherichia coli sepsis

Pericardial effusion (PE) is a rare condition in neonates and usually due to central venous catheters. Infective pericarditis is an extremely rare condition in neonates.

We describe a case of a preterm neonate with Escherichia coli pericarditis.

A preterm female neonate born at 34 weeks of gestation with a birth weight of 1600 grams was admitted because of respiratory distress. The patient was managed using a high-flow nasal cannula. She did not receive a central venous catheter or antibiotics. The outcome was good and the patient was discharged on day 14 of life. On day 18, she was readmitted because of fever and shortness of breath. Blood sample culture was positive for Escherichia coli. On day 21, the patient presented signs of heart failure. Chest radiography showed cardiomegaly. Cardiac ultrasound showed pre tamponade. Our patient was managed with pericardial drainage and cefotaxime administration. The outcome was good and further follow-up was unremarkable.

Even though rare, infective pericarditis with effusion should be suspected in neonates who show deterioration in respiratory and hemodynamic status even if they do not have central venous catheter.