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Purulent Pericarditis with Quadruple Valve Endocarditis

Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Huliyurdurga S. Setty Natrajsetty, Ishwarappa B. Vijayalakshmi, Chitra Narasimhan, Cholenahalli N. Manjunath

Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India

Am J Case Rep 2015; 16:236-239

DOI: 10.12659/AJCR.893072

Available online:

Published: 2015-04-23


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).
Case Report: 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.

Keywords: Anti-Bacterial Agents - therapeutic use, Child, Diagnosis, Differential, Echocardiography, Endocarditis, Bacterial - ultrasonography, Heart Valve Diseases - ultrasonography, Methicillin-Resistant Staphylococcus aureus - isolation & purification, Pericardiocentesis, Pericarditis - ultrasonography, Staphylococcal Infections - ultrasonography



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