title: Purulent pericarditis due to co-infection with Streptococcus pneumoniae and Mycobacterium tuberculosis in a patient with features of advanced HIV infection.
abstract: BACKGROUND
  Both Mycobacterium tuberculosis and Streptococcus pneumoniae are common pathogens in patients with HIV infection.
  
  
  METHODS
  We present an unusual case of purulent pericarditis resulting in cardiac tamponade due to infection with both organisms. We highlight the re-emergence of pneumococcal pericarditis in the HIV era and describe the pitfalls and challenges in the diagnosis of this condition.
  
  
  CONCLUSIONS
  Clinicians working in HIV endemic areas need to consider dual infection with these organisms in patients who respond inadequately to either antibiotics or anti-tuberculous therapy alone.
authors.affiliation: Department of Medicine, Chris Hani Baragwanath Hospital, Soweto, South Africa. andrewlouw@hotmail.com <andrewlouw@hotmail.com>
authors.forename: Andrew
authors.initials: A
authors.lastname: Louw
authors.forename: Mohammed
authors.initials: M
authors.lastname: Tikly
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D000995:Antitubercular Agents / Q000627:therapeutic use; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging* / Q000382:microbiology; D004359:Drug Therapy, Combination; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010495:Pericarditis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000188:drug therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents