title: Successful treatment of a patient with purulent pericarditis by daily intrapericardial washouts.
abstract: Purulent pericarditis in adults is rare, but once it develops, it carries a high mortality rate. Adequate pericardial drainage and proper antibiotic treatment are essential in the successful management of purulent effusions, for which percutaneous catheter drainage is the most commonly performed technique. We herein report the case of a 75-year-old woman with purulent pericarditis attributable to methicillin-resistant Staphylococcus aureus. Although percutaneous pericardial drainage by catheter was used, the drainage was insufficient because of hyperviscous effusion. We performed surgical subxiphoid pericardial drainage, and a piece of a purulent stone was found in the pericardial cavity with purulent effusion. Additionally, daily intrapericardial washouts with physiologic saline alone were used as adjunct therapy. Five weeks later, the patient had a decreasing inflammatory reaction and symptom relief. She was discharged with no complications such as constrictive pericarditis.
authors.affiliation: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Terada
authors.affiliation: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Akita, Japan. Electronic address: hirow@doc.med.akita-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kobukai
authors.affiliation: Department of Cardiovascular Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Department of Cardiovascular Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Mamika
authors.initials: M
authors.lastname: Motokawa
authors.affiliation: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D010493:Pericarditis / Q000628:therapy*; D013492:Suppuration / Q000628:therapy