1/6. Streptococcus acidominimus infections in a human.We described the first case of pneumonia, pericarditis and meningitis due to Streptococcus acidominimus, who had no underlying disease. The organism is very rarely obtained in clinical bacteriology. The identifying characteristics of this isolate were discussed. There are no reports in which this organism caused such complicated human infection as this case in the English literature.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
2/6. Pneumococcal pericarditis. Diagnostic usefulness of counterimmunoelectrophoresis and computed tomographic scanning.Although counterimmunoelectrophoresis (CIE) analysis of cerebrospinal fluid has proved useful in the diagnosis of meningitis, there has been little experience with its use in analyzing pericardial fluid. We describe two patients with pneumococcal pneumonia whose hospital course was complicated by purulent pericarditis. In one patient, results of a computed tomographic scan were important in suggesting the diagnosis. Results of a Gram's stain and culture of pericardial fluid failed to yield any organisms, presumably because both patients had received nine days of beta-lactam antibiotic therapy. However, the results from CIE analysis of pericardial fluid in both cases were positive for streptococcus pneumoniae. In one patient, for whom capsular typing of the organism was performed, the pneumococcus type isolated from pericardial fluid matched the type isolated previously from a blood sample. The results of CIE can allow focused antibiotic therapy by establishing the correct diagnosis.- - - - - - - - - - ranking = 5keywords = pericarditis (Clic here for more details about this article) |
3/6. 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 = 1keywords = pericarditis (Clic here for more details about this article) |
4/6. Acute and transient ST segment elevation during bacterial shock in seven patients without apparent heart disease.Acute elevation of the ST segment in several ECG leads was observed in seven patients with bacterial shock during the course of therapy. Six patients had bacterial pneumonia, one had acute cholecystitis, and none had a previous history of heart disease. At the onset of the ST elevation, all patients were receiving dopamine infusion, which in four of them was inadvertently increased shortly before the ECG changes, the ST elevation was not associated with chest pain, pericardial friction rub, or acute changes in the heart rate, or arterial blood pressure. In four patients the maximum ST elevation was greater than or equal to 5 mm. In each instance the ST segment returned to the isoelectric line within 24 hours, and subsequent development of Q waves or changes in the QRS was not observed. Although the existence of an acute pericarditis or an acute myocarditis as possible causes of the ST elevation cannot be fully ruled out, the sudden onset, prominent magnitude, and brief duration of the ST elevation are perhaps more indicative of an acute ischemic event, possibly related to a transient coronary vasoconstriction induced by the dopamine infusion.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
5/6. Catheter lavage and drainage of pneumococcal pericarditis.An 88 year old woman with streptococcal pneumonia developed purulent pericarditis and cardiac tamponade despite treatment with antibiotics. Percutaneous pericardial drainage was effected with a 6 French pigtail catheter inserted via the subxyphoid approach. Catheter drainage was continued for 7 days in conjunction with systemic antibiotics. Catheter patency was maintained with antibiotic lavage. Immediate hemodynamic improvement followed the initial pericardial drainage. fever, leukocytosis, and sepsis resolved during the course of therapy. The patient recovered fully from the closed space bacterial infection without additional surgical drainage. There has been no recurrence of streptococcal infection and no echocardiographic evidence of recurrent pericardial effusion after 3 months of follow-up. Indwelling catheter drainage combined with antibiotics may be an effective substitute for surgical drainage in the treatment of streptococcal pericarditis.- - - - - - - - - - ranking = 6keywords = pericarditis (Clic here for more details about this article) |
6/6. Pneumococcal pericarditis presenting as an out of hospital cardiopulmonary arrest.Serious complications of pneumococcal pneumonia have become uncommon with effective antibiotic treatment. Purulent pericarditis is a rare though well described complication of untreated pneumococcal sepsis. A case of untreated pneumococcal pneumonia complicated by purulent pericarditis is described. This presented as an out of hospital asystolic cardiopulmonary arrest.- - - - - - - - - - ranking = 6keywords = pericarditis (Clic here for more details about this article) |