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The frequency of pericardial effusions in bacterial meningitis
Abstract:
Because of our experience with four cases of purulent pericarditis complicating bacterial meningitis during a 13-month period, we performed a prospective study to determine the frequency of this complication. Echocardiograms were done on 100 patients with bacterial meningitis. Small or moderate pericardial effusions were detected in 19 patients, but none had symptoms or signs related to the effusion. Pericardiocentesis was done in one infant; all the other effusions resolved spontaneously. Patients with effusion were significantly younger than those without this complication, but no other significant risk factors were identified. A literature survey indicated that symptomatic pericarditis occurs in fewer than 1% of patients with meningitis. Conversely, in series of cases of purulent pericarditis, associated meningitis was reported in 12% of patients. We concluded that pericardial infection is common in patients with meningitis but that it is usually of no clinical significance and resolves with antibiotic therapy.
Insights
Purulent pericarditis is a common complication of bacterial meningitis, often presenting as asymptomatic pericardial effusion. This condition typically resolves with antibiotic treatment and is usually not clinically significant.
Area of Science:
- Infectious Diseases
- Cardiology
- Pediatrics
Background:
- Purulent pericarditis is a rare but serious complication of bacterial meningitis.
- Previous studies have focused on symptomatic cases, potentially underestimating the frequency of pericardial involvement.
Purpose of the Study:
- To determine the frequency of pericardial effusion in patients with bacterial meningitis.
- To identify risk factors and clinical significance of pericardial effusion in this population.
Main Methods:
- Prospective study involving 100 patients diagnosed with bacterial meningitis.
- Echocardiography was performed to detect pericardial effusions.
- Literature review of purulent pericarditis and associated meningitis.
Main Results:
- Pericardial effusion was detected in 19% of patients with bacterial meningitis.
- Effusions were small to moderate and asymptomatic in all cases.
- Younger age was the only significant risk factor identified for effusion development.
Conclusions:
- Pericardial infection is a frequent complication of bacterial meningitis, often subclinical.
- Pericardial effusions in this context are typically benign and resolve with standard antibiotic therapy.
- Symptomatic purulent pericarditis is rare, but meningitis is a notable comorbidity in purulent pericarditis cases.