Cardiac tamponade secondary to methicillin-resistant Staphylococcus aureus pericarditis.
Since the advent of antibiotics, bacterial pericarditis has become relatively rare. Cardiac tamponade is a potentially lethal complication, especially when caused by methicillin-resistant Staphylococcus aureus (MRSA). In the intensive care setting other predisposing factors for purulent pericarditis, besides immunosuppression, are the high incidence of nasal and skin colonization and invasive techniques such as indwelling catheters. We present two case reports of cardiac tamponade in young patients, with underlying immunosuppression of different etiologies (HIV infection and liver transplantation). In both, clinical evolution was complicated by severe sepsis, with MRSA being isolated in various biological products, followed by bacterial pericarditis and tamponade. The authors highlight the need for a high degree of suspicion for the diagnosis of bacterial pericarditis in immunosuppressed patients, an ever-growing population, as well as the importance of echocardiographic monitoring during clinical evolution.
Durão
David
D
Unidade de Cuidados Intensivos, Hospital Curry Cabral, Lisboa, Portugal. davidluisdurao@hotmail.com
Fernandes
Ana Paula
AP
Marum
Susan
S
Marcelino
Paulo
P
Mourão
Luís
L
D000328:Adult; D002305:Cardiac Tamponade / Q000209:etiology*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016106:Methicillin Resistance; D010493:Pericarditis / Q000150:complications* / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000150:complications*