1/11. Purulent pneumococcal pericarditis: a rarity in the antibiotic era.PURPOSE: The purpose of this report is to show that even while properly treated, pneumococcal disease may proceed to a life-threatening condition including purulent pericarditis and multiple organ failure. patients AND methods: This is a case-report describing one patient treated in the intensive care unit (ICU) of Helsinki University Central Hospital in March 2001. CONCLUSIONS: In the antibiotic era, purulent pericarditis is an extremely rare yet possible condition complicating pneumococcal disease. Because of the growing incidence of penicillin resistance of this community-acquired pathogen, purulent pericarditis may become more common. Early detection and treatment of this otherwise fatal condition may lead to a good outcome.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
2/11. Rapid evolution of cardiac tamponade due to bacterial pericarditis in two patients with hiv-1 infection.We describe two HIV-seropositive patients with acute pneumococcal empyema and pericarditis. cardiac tamponade evolved rapidly in each patient and was reversed with prompt surgical intervention. In each case, immunologic abnormalities were detected which could have facilitated local spread of infection and progression to tamponade. pericarditis, an otherwise rare manifestation of pneumococcal infection in the antibiotic era, should be anticipated in HIV-seropositive patients with pneumococcal empyema.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
3/11. A preventable illness? Purulent pericarditis due to streptococcus pneumoniae complicated by haemolytic uraemic syndrome in an infant.A previously healthy eight-month-old infant presented with shortness of breath and pyrexia. He was found to have purulent pericarditis due to streptococcus pneumoniae, complicated by acute renal failure due to haemolytic uraemic syndrome. He received peritoneal dialysis and recovered with normalisation of renal function. This case highlights two important complications of pneumococcal infection in one individual and illustrates the need for rapid diagnosis and treatment of invasive pneumococcal disease. It is anticipated that introduction of the conjugate pneumococcal vaccination to the Australian Standard vaccination Schedule from 2005 will reduce the incidence of pneumococcal infection and its associated morbidity and mortality.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
4/11. Disseminated pneumococcal infection with pericarditis and cardiac tamponade: report of one case.A 1-year-5-months-old female who had cough, rhinorrhea and prolonged fever for 19 days was admitted to the intensive care unit due to exertional dyspnea. She was intubated promptly in virtue of hypotension and cyanosis. The physical examination demonstrated diminished breathing sound over the right lung and distant heart sound; echocardiogram showed cardiac tamponade. Further X ray study showed right hydropneumothorax and cardiomegaly. pericardiocentesis and chest thoracostomy were performed, and subsequently all the cultures showed growth of streptococcus pneumoniae. Antibiotics therapy was started promptly after admission. Further investigation indicated osteomyelitis of the right ilium, so that surgical debridement was done. The patient was discharged 54 days later with complete recovery. After following up for 18 months, no restrictive heart disease developed. Purulent pericarditis with cardiac tamponade is an extremely rare complication of pneumococcal infection.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
5/11. Pneumococcal pericarditis successfully treated with catheter drainage and intravenous antibiotics.Bacterial pericarditis is commonly a disease of children for which the primary treatment is surgical drainage. We report the case of a 19-yr-old patient presenting with pneumococcal pericarditis and tamponade treated successfully with intrapericardial catheter drainage and intravenous antibiotics. The technical aspects are discussed.- - - - - - - - - - ranking = 0.85714285714286keywords = pericarditis (Clic here for more details about this article) |
6/11. Purulent pericarditis in children.Acute purulent pericarditis was treated successfully in five children between the ages of 27 months and 11 1/2 years during the past 5 years. The responsible organism was Hemophilus influenzae, type b, in two cases and Meningococcus, Pneumococcus, and coagulase-positive staphylococcus aureus in one case each. No primary source of infection could be identified in two patients. A high index of suspicion, combined with immediate echocardiograms and pericardiocentesis, led to the diagnosis. Immediate antibiotic therapy was instituted on the basis of the gram stain of the pericardial fluid. All five patients had a pericardial window established--four through subxyphoid approach and the fifth, because of a left pleural effusion, through a left thoracotomy. When the subxyphoid approach was used, sump drains were left for postoperative suction and irrigation. All five patients survived without sequalae during follow-up periods of from 18 months to 5 years. We advocate an aggressive approach to the diagnosis and treatment of this problem. This report documents the safety, ease, and effectiveness of the subxyphoid approach as a means of drainage.- - - - - - - - - - ranking = 0.71428571428571keywords = pericarditis (Clic here for more details about this article) |
7/11. Acute nontraumatic cardiac tamponade.A 33-year-old man presented with acute nontraumatic cardiac tamponade as a result of pneumococcal pericarditis in association with pneumococcal pneumonia. hypotension, tachycardia and pulsus paradoxicus, 50 mm Hg, were present. Echocardiographic findings were compatible with cardiac tamponade. pericardiocentesis was performed. Acute nontraumatic pericardial tamponade in the emergency department presents special problems of diagnosis and management. diagnosis is based on correlation of data from the history, physical examination, electrocardiogram, chest x-ray films, and a high index of suspicion. echocardiography to confirm the diagnosis of tamponade and aid in correct placement of the needle in pericardiocentesis is especially helpful.- - - - - - - - - - ranking = 0.14285714285714keywords = pericarditis (Clic here for more details about this article) |
8/11. Primary pneumococcal pericarditis complicated by acute constriction.We report a case of a 31-year-old male with primary pneumococcal pericarditis. Severe acute constrictive pericarditis developed within a month of the onset of the illness in spite of adequate antibiotic therapy and pericardial drainage.- - - - - - - - - - ranking = 0.85714285714286keywords = pericarditis (Clic here for more details about this article) |
9/11. Pneumococcal pericarditis: a persisting problem in contemporary diagnosis.We reviewed the clinical and laboratory features of six patients with pericarditis caused by streptococcus pneumoniae who were admitted to boston City Hospital. The diagnosis of pneumococcal pericarditis was delayed or missed entirely during life in all patients. The frequent absence of pericardial friction rubs and cardimegaly on chest roentgenograms contributed to the difficulty in recognizing this illness. Electrocardiograms and physical examinations of the heart almost always disclosed abnormalities, but they were not sufficiently specific to suggest pericarditis, and patients were often thought to have had an acute complication of arteriosclerotic heart disease. review of the English literature since 1945 supports the recent experience in our hospital that the diagnosis of pneumococcal pericarditis may be elusive.- - - - - - - - - - ranking = 1.1428571428571keywords = pericarditis (Clic here for more details about this article) |
10/11. Pneumococcal pericarditis--out of sight, out of mind?Pneumococcal pericarditis has been an uncommon condition in recent years. This report describes the case of a 57-year-old woman with sarcoidosis who presented with cardiac tamponade due to pneumococcal pericarditis. She responded to pericardiocentesis and intravenous antibiotic therapy. At 4-month review, she remains well.- - - - - - - - - - ranking = 0.85714285714286keywords = pericarditis (Clic here for more details about this article) |
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