title: Pneumococcal pericarditis with cardiac tamponade in a patient with chronic graft-versus-host disease.
abstract: We report a case of pneumococcal pericarditis in a 13-year-old boy following allogeneic BMT from an HLA-identical unrelated donor. The post-transplant course was complicated by chronic GVHD which led to reinstitution of immunosuppressive therapy. Eight months after BMT the patient developed pericarditis with cardiac tamponade, and Streptococcus pneumoniae was isolated in the pericardiocentesis fluid. This is the first reported case of pneumococcal pericarditis after BMT. Although pericardial effusions after allogeneic BMT are often sterile and related to conditioning therapy or associated with chronic GVHD, rapid microbiological investigation and empirical treatment with antibiotics are necessary. Prophylaxis for pneumococcal infection in patients with chronic GVHD is recommended.
authors.affiliation: Servicio de Hematología, Hospital Universitario Marqués de Valdecilla, Facultad de Medicina Universidad de Cantabria, Santander, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Pérez Retortillo
authors.forename: F
authors.initials: F
authors.lastname: Marco
authors.forename: C
authors.initials: C
authors.lastname: Richard
authors.forename: E
authors.initials: E
authors.lastname: Conde
authors.forename: R
authors.initials: R
authors.lastname: Manjón
authors.forename: E
authors.initials: E
authors.lastname: Bureo
authors.forename: A
authors.initials: A
authors.lastname: Iriondo
authors.forename: A
authors.initials: A
authors.lastname: Zubizarreta
mesh_terms: D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002305:Cardiac Tamponade / Q000150:complications*; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000628:therapy; D008297:Male; D010493:Pericarditis / Q000150:complications / Q000209:etiology*; D011008:Pneumococcal Infections / Q000150:complications / Q000209:etiology*