title: Pericarditis caused by anaerobic bacteria.
abstract: This review describes the microbiology, diagnosis and management of pericarditis due to anaerobic bacteria. The predominant anaerobes isolated from patients with pericarditis are Gram-negative bacilli (mostly Bacteroides fragilis group) as well as Peptostreptococcus, Clostridium, Fusobacterium, Bifidobacterium and Actinomyces spp. Anaerobic bacteria can be recovered from pericarditis resulting from the following mechanisms: (i) spread from a contiguous site of infection, either de novo or following surgery or trauma (pleuropulmonary, oesophageal fistula or perforation, and odontogenic); (ii) spread from a site of infection within the heart, most commonly from endocarditis; (iii) haematogenous infection; and (iv) direct inoculation resulting from a penetrating injury or cardiothoracic surgery. Anaerobic Gram-negative bacilli have increased their resistance to penicillins and other antimicrobial agents in the last two decades. Identification of pathogens and determination of their antimicrobial susceptibility and beta-lactamase production are essential for adequate selection of antibiotic therapy effective against these organisms.
authors.affiliation: Department of Pediatrics and Medicine, Georgetown University School of Medicine, Washington, DC 20016, USA. ib6@georgetown.edu
authors.forename: Itzhak
authors.initials: I
authors.lastname: Brook
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001421:Bacteria, Anaerobic / Q000145:classification* / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D019090:Case Management; D006801:Humans; D008826:Microbial Sensitivity Tests; D010493:Pericarditis / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents