title: Intrapericardial streptokinase for purulent pericarditis.
abstract: OBJECTIVE
  Purulent pericarditis has become a rare disease since the introduction of antibiotics into clinical practice. Standard management consists of antibiotics and surgical drainage. In this study we also instilled streptokinase to obliterate the loculations and fibrin strands in patients with purulent pericarditis.
  
  
  METHODS
  Between October 1997 and October 2002, we treated nine children with purulent pericarditis by pericardial drainage with streptokinase instillation and antibiotics. There were five boys and four girls aged between 3 and 13 years, with a mean age of 6.7 +/- 2.9 years.
  
  
  RESULTS
  Pericardiocentesis revealed purulent effusion of 180-650 ml in the pericardial space in all patients. Blood pressure increased and central venous pressure decreased after the pericardial empyema was evacuated in all patients. None of the patients had systemic bleeding, arrhythmias, or hypotension suggesting an anaphylactic reaction.
  
  
  CONCLUSIONS
  We found intrapericardial streptokinase to be safe and effective for dissolving fibrin layers and removing loculations, resulting in complete pericardial drainage. Therefore, intrapericardial streptokinase should be instilled to prevent constrictive pericarditis.
authors.affiliation: Department of Cardiovascular Surgery, Yüzüncü Yil University School of Medicine, 65200 Van, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ekim
authors.forename: Recep
authors.initials: R
authors.lastname: Demirbağ
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology; D020519:Pericardiocentesis; D010493:Pericarditis / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*; D013492:Suppuration
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase