Purulent pericarditis due to Streptococcus pneumoniae diagnosed by pneumococcal urinary antigen assay and 16S rDNA sequence of the pericardial fluid.
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.
Nakagawa
Chiyo
C
Center for Infectious Diseases, Nara Medical University, Kashihara.
Kasahara
Kei
K
Yonekawa
Shinsuke
S
Ogawa
Taku
T
Kutsuna
Satoshi
S
Maeda
Koichi
K
Konishi
Mitsuru
M
Kikuchi
Ken
K
Mikasa
Keiichi
K
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*
D000942:Antigens, Bacterial; D015415:Biomarkers; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S