[Pericarditis caused by Gemella morbillorum. Description of a case]

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Microbiology

Background:

• Pericardial diseases in children are uncommon, often linked to viral infections or autoimmune conditions.
• Bacterial pericarditis is rare post-antibiotics, with common culprits including Staphylococcus aureus and Streptococcus pneumoniae.
• Gemella morbillorum, a Gram-positive bacterium typically found in the GI tract, is an infrequent cause of serious human infections.

Observation:

• A case of a pediatric patient presenting with persistent chest pain and significant pericardial effusion unresponsive to initial broad-spectrum treatments.
• Echocardiography revealed approximately 18 mm of pericardial fluid, indicating a severe effusion.
• Despite treatment with diuretics, broad-spectrum antibiotics, and steroids, the patient's condition and laboratory values did not improve.

Findings:

• Pericardial drainage led to the isolation of Gemella morbillorum as the causative agent of pyogenic pericarditis.
• Tailoring antimicrobial therapy based on Gemella morbillorum's in vitro susceptibility was crucial for patient recovery.
• Recurrence of pericardial effusion necessitated a prolonged course of steroid therapy (5 months).

Implications:

• This case highlights Gemella morbillorum's potential to act as a pathogen in previously healthy individuals.
• It underscores the importance of accurate etiological diagnosis for pericarditis cases resistant to standard antibiotic regimens.
• Identifying rare pathogens like Gemella morbillorum is vital for effective treatment and improved outcomes in pediatric pericarditis.