Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease
Arjun Kanwal, Dimitrios Avgeropoulos, Jason G. Kaplan, Aditya Saini
Department of Internal Medicine, MedStar Health Internal Medicine Residency Program, Baltimore, MD, USA
Am J Case Rep 2020; 21:e921633
Available online: 2020-01-24
Acute bacterial pericarditis is rare, and the incidence numbers have been declining in the modern antibiotic era. Purulent bacterial pericarditis is a fatal disease in which mortality rates can reach 100% if left untreated.
CASE REPORT: We present a case of primary purulent bacterial pericarditis with polymicrobial growth including Micromonas micro, Prevotella intermedia and Fusobacterium species, all of which are anaerobic flora of the oral cavity. Constant re-accumulation of the purulent pericardial effusion led the patient to have recurrent echocardiographic and clinical cardiac tamponade requiring recurrent pericardiocentesis’ and eventually a pericardial window.
CONCLUSIONS: Although rare, bacterial pericarditis has been noted to lead to clinical and echocardiographic tamponade. Early diagnosis and treatment are necessary for improving clinical outcomes. It is important to have a suspicion for purulent pericarditis, due to its high level of mortality, in patients who present with non-specific symptoms and pleuritic chest pain.
Keywords: Bacteria, Anaerobic, Cardiac Tamponade, Pericarditis