title: Needle in the haystack: purulent pericarditis from injection drug use.
abstract: Central needle embolization is a rare complication of intravenous drug abuse which has only been reported on a handful of occasions. Previously reported cases of needle embolization to the heart have been managed conservatively (observation alone) or by surgical intervention. We report a case of purulent pericarditis without evidence of valvular vegetations resulting from an embolized, infected needle fragment. In the present case, the needle was successfully removed from the right ventricle percutaneously. This case illustrates the unique finding of purulent pericarditis due to a persistent foreign body in the right ventricle, and the nontraditional intervention performed for needle fragment removal which resulted in full clinical recovery of the patient.
authors.affiliation: Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
authors.forename: Johannes
authors.initials: J
authors.lastname: Steiner
authors.forename: Ravi
authors.initials: R
authors.lastname: Dhingra
authors.forename: James T
authors.initials: JT
authors.lastname: Devries
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006328:Cardiac Catheterization; D020878:Device Removal; D004562:Electrocardiography; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009339:Needles / Q000382:microbiology; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D015641:Radiography, Interventional; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents