title: Acute Primary Pneumococcal Purulent Pericarditis With Cardiac Tamponade: A Case Report and Literature Review.
abstract: Bacterial pericarditis is a rapidly progressive and highly fatal infection, and is often diagnosed postmortem in half of the cases. Even with drainage and antibiotics, the mortality rate is high. Gram-positive cocci, specifically Streptococcus penumoniae, have been the most common cause of bacterial pericarditis with a preceding primary site of infection. Following the introduction of antibiotics in the 1940s and more recently the pneumococcal conjugate vaccine, the incidence has drastically decreased.We describe an extremely rare case of primary streptococcus pneumoniae purulent pericarditis that presented with cardiac tamponade. The patient was successfully treated with broad-spectrum antibiotics and urgent pericardiocentesis.Due to the high mortality rate with purulent pericarditis, a high index of suspicion is needed when acute pericarditis is suspected for early diagnosis to instate appropriate therapy with antibiotics and drainage.
authors.affiliation: From the Baton Rouge General Medical Center, an affiliate of Tulane University School of Medicine, Baton Rouge, Louisiana (HP, CP, VB); Cardiovascular Institute of the South, Zachary, Louisiana (MS); and Cardiovascular Institute of the South, Baton Rouge, Louisiana (AP).
authors.forename: Hiren
authors.initials: H
authors.lastname: Patel
authors.forename: Charmi
authors.initials: C
authors.lastname: Patel
authors.forename: Mrugesh
authors.initials: M
authors.lastname: Soni
authors.forename: Amit
authors.initials: A
authors.lastname: Patel
authors.forename: Venkat
authors.initials: V
authors.lastname: Banda
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004322:Drainage; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D010493:Pericarditis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D011008:Pneumococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D013902:Radiography, Thoracic; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents