The unmasking of a pyopericardium.
Pyopericardium is a rare condition with a high mortality rate in which infection propagates in the pericardial space, leading to a pus filled pericardial effusion and cardiac tamponade, which can cause cardiogenic shock and death. We present a case of a previously healthy woman of 52, who was admitted with a severe lower respiratory tract infection that eventually led to a pyopericardium. The diagnosis of pyopericardium was delayed due to masking of symptoms by her underlying infection, sepsis and an upper gastrointestinal bleed that the patient suffered during the admission, requiring an emergency gastroscopy. The pyopericardium was considered when ST elevation was seen on an ECG and an ECHO discovered a large pericardial effusion causing tamponade. An emergency pericardiocentesis drained frank pus. Treatment with intravenous antibiotics, frequent pericardial drainage and a pericardectomy led to an excellent outcome, and a full recovery.
James Paget Hospital, Great Yarmouth, UK.
Benjamin Robert Syer
BR
Cracknell
James Paget Hospital, Great Yarmouth, UK.
Dhiraj
D
Ail
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D057210:Delayed Diagnosis; D004322:Drainage; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D010492:Pericardiectomy; D010496:Pericardium; D012141:Respiratory Tract Infections / Q000150:complications*; D013492:Suppuration / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents