title: Purulent pericarditis due to Streptococcus pneumoniae diagnosed by pneumococcal urinary antigen assay and 16S rDNA sequence of the pericardial fluid.
abstract: A 57-year old woman was admitted to our hospital with massive pericardial fluid. Culture of the pericardial fluid was negative, however, Binax NOW Streptococcus pneumoniae urinary antigen test was positive in pericardial fluid. 16S rDNA sequencing and PCR for lyt(A) gene of the pericardial fluid sample confirmed the microbiological diagnosis of S. pneumoniae. The patient was treated with surgical drainage and continuous intravenous infusion of penicillin G and its concentration in the serum and pericardial effusion was monitored. Incorporation of molecular methods such as antigen testing and nucleic acid sequencing would benefit the management of infectious diseases especially in culture negative cases.
authors.affiliation: Center for Infectious Diseases, Nara Medical University, Kashihara.
authors.forename: Chiyo
authors.initials: C
authors.lastname: Nakagawa
authors.forename: Kei
authors.initials: K
authors.lastname: Kasahara
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Yonekawa
authors.forename: Taku
authors.initials: T
authors.lastname: Ogawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kutsuna
authors.forename: Koichi
authors.initials: K
authors.lastname: Maeda
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Konishi
authors.forename: Ken
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Mikasa
mesh_terms: D000942:Antigens, Bacterial / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D004275:DNA, Ribosomal / Q000652:urine; D005260:Female; D006801:Humans; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000652:urine; D010493:Pericarditis / Q000175:diagnosis* / Q000652:urine*; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000652:urine; D012336:RNA, Ribosomal, 16S / Q000652:urine*; D013296:Streptococcus pneumoniae / Q000276:immunology*
chemical_list: D000942:Antigens, Bacterial; D015415:Biomarkers; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S