Purulent pericarditis and pneumonia caused by Streptococcus equi subsp. zooepidemicus.
Purulent pericarditis is a life-threatening disease that usually manifests following bacteraemia or through spreading from an intrathoracic focus. Only a few cases of this disease have been reported with Lancefield group C streptococci as aetiological agents, and the primary focus in these infections remains unknown. We report a case of purulent pericarditis with septic and cardiogenic shock, caused by Streptococcus equi subsp. zooepidemicus (group C) in a 51-year-old patient. The pathogen was possibly contracted through contact with horses. Most probably, it caused initially pneumonia before spreading to the pericardium, either directly or via the bloodstream. A combined therapeutic approach, consisting of antibiotic therapy and repeated pericardial drainage, was necessary to ensure a clinical cure. After discharge, long-term follow-up for development of constrictive pericarditis is considered mandatory.
Institute of Medical Microbiology and Hygiene, University Medical Centre Freiburg, 79104 Freiburg, Germany.
Jürgen
J
Held
Department of Clinical Cardiology I, Heart Center Freiburg University, 79189 Bad Krozingen, Germany.
Roland
R
Schmitz
National Reference Center for Streptococci, Department of Medical Microbiology, University Hospital RWTH Aachen, 52074 Aachen, Germany.
Mark
M
van der Linden
Department of Clinical Cardiology I, Heart Center Freiburg University, 79189 Bad Krozingen, Germany.
Thomas
T
Nührenberg
Institute of Medical Microbiology and Hygiene, University Medical Centre Freiburg, 79104 Freiburg, Germany.
Georg
G
Häcker
Department of Clinical Cardiology I, Heart Center Freiburg University, 79189 Bad Krozingen, Germany.
Franz-Josef
FJ
Neumann
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage; D004452:Echocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D018410:Pneumonia, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013902:Radiography, Thoracic; D012772:Shock, Septic / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D013291:Streptococcus; D018502:Streptococcus equi / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents