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Cardiac tamponade due to Nocardia asteroides
T L Clenney1, M D Hammond, P P McKeown
1Department of Internal Medicine, University of South Florida College of Medicine, Tampa 33612.
Chest
|February 1, 1993
Summary
Pericarditis caused by Nocardia asteroides is rare, especially with hemodynamic compromise. Diagnosis can be challenging, as pericardial tissue culture, not fluid, confirmed the infection in this case.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Nocardia asteroides infection can cause pericarditis, a serious inflammation of the sac surrounding the heart.
- Cases of Nocardia pericarditis with hemodynamic compromise are exceptionally rare, with limited prior reports.
Observation:
- This report details a unique case of Nocardia asteroides pericarditis presenting with hemodynamic compromise.
- Pericardial fluid cultures were negative, complicating the initial diagnosis.
- Diagnosis was established through positive Nocardia asteroides cultures from pericardial tissue.
Findings:
- Culture of pericardial tissue is crucial for diagnosing Nocardia pericarditis when fluid cultures are negative.
- Prompt surgical intervention and targeted antibiotic therapy are vital for successful treatment.
Implications:
- Highlights the importance of considering pericardial tissue biopsy in suspected Nocardia pericarditis, even with negative fluid cultures.
- Emphasizes the critical role of combined surgical and antibiotic management for this rare condition.
- Contributes to the limited understanding of Nocardia asteroides' impact on the pericardium.
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