title: Diagnostic value of the biochemical tests in patients with purulent pericarditis.
abstract: OBJECTIVE
  Purulent pericarditis is a collection of purulent effusion in the pericardial space. It has become a rare entity with the increased availability and use of antibiotics. In contrast to pleural empyema, there are few data regarding the biochemical parameters of purulent pericardial effusion to aid diagnosis. Therefore, in this study, we have evaluated the diagnostic utility of biochemical tests in patients with purulent pericarditis.
  
  
  METHODS
  Between September 2004 and September 2012, we treated fifteen children with purulent pericarditis and tamponade. There were 8 boys and 7 girls, ranging in age from 8 months to 14 years, with a mean age of 5.3 ± 3.2 years. Echocardiographic diagnosis of cardiac tamponade was made in all patients. All patients underwent immediate surgical drainage due to cardiac tamponade. The diagnosis of purulent pericarditis was supported by biochemical tests. Anterior mini-thoracotomy or subxiphoid approach was performed for surgical drainage.
  
  
  RESULTS
  The most common clinical findings were tamponade, hepatomegaly, tachycardia, fever refractory antibiotic therapy, dyspnea, tachypnea, cough, and increased jugular venous pressure. Central venous pressure decreased and arterial tension increased immediately after the evacuation of purulent effusion during operation in all patients. The pericardial effusion had high lactic dehydrogenase, and low glucose concentration, confirming purulent pericarditis. Also, pH (mean± SD) was 7.01 ± 0.06. The culture of pericardial effusions and blood samples were negative.
  
  
  CONCLUSIONS
  Biochemical tests are useful guideline when assessing the pericardial effusions. However, these tests should be interpreted with the clinical and operative findings.
authors.affiliation: Meral Ekim, MD, Department of Biochemistry, Bozok University School of Medicine, Yozgat, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Ekim
authors.affiliation: Hasan Ekim, MD, Department of Cardiovascular Surgery, Bozok University School of Medicine, Yozgat, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ekim
keywords: Biochemical Tests; Pericarditis; Purulent Effusion
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