Purulent pericarditis in childhood: ten years of experience.
OBJECTIVE
Purulent pericarditis is a rapidly fatal disease if left untreated. This article describes our experience with diagnosis and management of 18 patients seen over a 10-year period.


METHODS
Eighteen children with purulent pericarditis were treated in our clinics between 1990 and 2000. Ten patients were boys and 8 were girls, and the mean age of all patients was 4 years (range, 8 months to 12 years).


RESULTS
Most common findings were fever and cardiac tamponade. Staphylococcus aureus was the most common causative agent, and the most common predisposing factor was respiratory tract infection. Chest radiography and echocardiography were the most important methods for diagnosis, and pericardiosynthesis was diagnostic in purulent pericarditis. The treatment methods performed in our patients were subxiphoidal pericardial tube (10 patients), pericardiectomy after subxiphoidal pericardial tube (2 patients), pericardiectomy (3 patients), and pericardiocentesis-intrapericardial thrombolytic treatment (3 patients). Only one patient (5.5%) died who was critically ill at the time of admission.


CONCLUSIONS
Subxiphoidal tube drainage and pericardiectomy were performed with good results in these cases. Intrapericardial streptokinase and pericardial aspiration method also was thought to be beneficial.
Cakir
Omer
O
Department of Thoracic and Cardiovascular Surgery, in Dicle University, School of Medicine, Diyarbakir, Turkey.
Gurkan
Fuat
F
Balci
Akin Eraslan
AE
Eren
Nesimi
N
Dikici
Bünyamin
B
D000367:Age Factors; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods; D004452:Echocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D010492:Pericardiectomy; D020519:Pericardiocentesis; D010493:Pericarditis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D013300:Streptokinase / Q000627:therapeutic use; D013492:Suppuration; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D013300:Streptokinase