Human immunodeficiency virus infection in a child revealed by a massive purulent pericarditis mistaken for a liver abscess due to Staphylococcus aureus

Abstract

Massive purulent andacute pericarditis in children is a life-threatening disease associated with high mortality. It has been described tocomplicate usuallya bronchopulmonary infectionbut is currently uncommon in the era of antibiotics. Acute and massive purulent pericarditis has been rarely reported in children in association with human immunodeficiency virus (HIV) infection. This is a case of a10-year-old boy who presented with signs of sepsis and cardiac tamponade due to a massive staphylococcal purulent pericarditis complicating an unknown HIV infection. The child underwent pericardiectomy, intensive treatment, and survived this life-threatening disease.

Hemopericardio, taponamiento cardíaco, y absceso hepático en un varón joven

“…Tuberculosis and viruses are the main causes of pericarditis; a condition categorized as fibrinous, fibrinous purulent, unspecific chronic, hemorrhagic, granulomatous, caseous, constrictive, post-myocardial infarction, and Dressler's syndrome. 2,4,16,19 Hemopericardium is usually associated with tuberculosis, malignant infiltration, and previous cardiac surgery; 2,16,19 in the present case study the hemorrhagic fluid had a relationship with S. aureus infection. 3 Worthy of note, this agent has been very often associated with blood borne dissemination, evolving to sepsis or shock with acute tubular necrosis, and also myocardial abscess.…”

“…Cardiac tamponade is reported as a severe complication in nearly 15% of acute purulent pericarditis caused by community acquired infection by Staphylococcus aureus, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] agent that has been described in up to 36% of purulent effusions in this group of patients. 1 Pericardial involvement more often occurs during bloodstream infections, but may origin as an extension of contiguous infectious foci; the main risk factors of this condition include immunosuppression, thoracic surgery, and percutaneous invasive procedure.…”

“…1 Pericardial involvement more often occurs during bloodstream infections, but may origin as an extension of contiguous infectious foci; the main risk factors of this condition include immunosuppression, thoracic surgery, and percutaneous invasive procedure. 1,2,4,9,[14][15][16] Additionally to infections, malignancy, myocardial infarction, autoimmune diseases, uremia, hypothyroidism, radiation, drugs, and iatrogenesis can cause www.medigraphic.org.mx www.medigraphic.org.mx dissection, malignancy, trauma, uremia, tuberculosis and drugs. 2,[16][17][18][19] Worthy of note is the overlapping of hemorrhagic with other type of pericardial effusion, as described in cardiac tamponade due to purulent pericarditis by Staphylococcal infection.…”

“…1,2,4,9,[14][15][16] Additionally to infections, malignancy, myocardial infarction, autoimmune diseases, uremia, hypothyroidism, radiation, drugs, and iatrogenesis can cause www.medigraphic.org.mx www.medigraphic.org.mx dissection, malignancy, trauma, uremia, tuberculosis and drugs. 2,[16][17][18][19] Worthy of note is the overlapping of hemorrhagic with other type of pericardial effusion, as described in cardiac tamponade due to purulent pericarditis by Staphylococcal infection. 6,17 The modality of drainage procedure is not yet consensual and depends upon the type of effusion, general patient health, physician experience, and institutional resources.…”

Massive purulent pericarditis in HIV-infected children

“…The report on “massive purulent pericarditis in HIV-infected children” is very interesting. [ 1 ] Bernadette et al . concluded that “massive purulent pericarditis is quite uncommon, but may still be found in HIV-infected children.”[ 1 ] In fact, the infectious cause of purulent pericarditis should be kept in mind when one deals with unexplained cardiac tamponade.…”