title: Pneumonia and purulent pericarditis caused by Streptococcus pneumoniae: an uncommon association in the antibiotic era.
abstract: Bacterial pericarditis in children has become a rare entity in the modern antibiotic era. The most common pathogen is Staphylococcus aureus, being Streptococcus pneumoniae an exceptional cause. We present 2 children, who were diagnosed of pneumonia complicated with a pleural effusion that developed a purulent pericarditis with signs of cardiac tamponade. One of them had received 4 doses of the 7-valent conjugated pneumococcal vaccine. Systemic antibiotics and pericardial and pleural drainages were used. Pneumococcal antigens were positive in pleural and pericardial fluids in both cases, and S. pneumoniae was isolated from pleural effusion in one of them. Both children fully recovered, and none of them developed constrictive pericarditis, although 1 case presented a transient secondary left ventricular dysfunction. Routine immunization with 10- and 13-valent vaccines including a wider range of serotypes should further decrease the already low incidence.
authors.affiliation: From the *Pediatric Intensive Care Unit, †Pediatric Cardiology Unit, and ‡Pediatric Research, Hospital Universitario Puerta del Mar, Cádiz, Spain.
authors.forename: Jose Carlos
authors.initials: JC
authors.lastname: Flores-González
authors.forename: Fernando
authors.initials: F
authors.lastname: Rubio-Quiñones
authors.forename: Arturo
authors.initials: A
authors.lastname: Hernández-González
authors.forename: Moisés
authors.initials: M
authors.lastname: Rodríguez-González
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Blanca-García
authors.forename: Alfonso María
authors.initials: AM
authors.lastname: Lechuga-Sancho
authors.forename: Sebastián
authors.initials: S
authors.lastname: Quintero-Otero
mesh_terms: D000942:Antigens, Bacterial / Q000302:isolation & purification; D002675:Child, Preschool; D015897:Comorbidity; D006801:Humans; D008297:Male; D010493:Pericarditis / Q000453:epidemiology* / Q000382:microbiology*; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology*; D013296:Streptococcus pneumoniae / Q000276:immunology / Q000302:isolation & purification; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000942:Antigens, Bacterial