title: Purulent pericarditis with quadruple valve endocarditis.
abstract: BACKGROUND
  Infective endocarditis (IE) is a disease with a highly varied clinical picture. Spread of the infection to the pericardium from the infective endocardium is uncommon and IE involving all 4 cardiac valves is also a very rare occurrence, being more common in intravenous drug users (IVDU).
  
  
  METHODS
  A 7-year-old boy had purulent pericarditis with infective endocarditis (IE) on all 4 cardiac valves and vegetation in the left ventricular and right atrial cavity. Culture of the pericardial fluid grew methicillin-resistant staphylococcus aureus (MRSA) sensitive to tigecycline. The child made a dramatic improvement with tigecycline treatment.
  
  
  CONCLUSIONS
  Aggressive management with pericardiocentesis and appropriate antibiotics can show remarkable clinical improvement. Tigecycline can be used safely and effectively as a life-saving drug in children.
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Huliyurdurga S Setty
authors.initials: HS
authors.lastname: Natrajsetty
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Ishwarappa B
authors.initials: IB
authors.lastname: Vijayalakshmi
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Chitra
authors.initials: C
authors.lastname: Narasimhan
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Cholenahalli N
authors.initials: CN
authors.lastname: Manjunath
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D003937:Diagnosis, Differential; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D020519:Pericardiocentesis; D010493:Pericarditis / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents