<i>Streptococcus pyogenes</i>Pericarditis with Resultant Pulmonary Trunk Compression Secondary to Mycotic Pseudoaneurysm

Fry, Ethan; Urbanczyk, Jonathan; Price, Jonathan; DiGiovanni, Robert J.; Jepson, Matthew J.; Gantt, D. Scott

doi:10.1155/2018/3514797

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Purulent bacterial pericarditis is a rare phenomenon in children, presenting as acute pericarditis with signs of systemic inflammation and symptoms such as chest pain, dyspnea, and fever. 1 GAS, or Streptococcus pyogenes, as an etiology of purulent bacterial pericarditis is even more rare with only about 7 reports in the literature 2 , 3 , 4 , 5 , 6 , 7 , 8 and none with pericardial mass/phlegmon formation.…”

Section: Discussionmentioning

confidence: 99%

“…Of the reported cases of purulent pericarditis in pediatric patients, 2 , 3 , 4 , 5 , 6 , 7 , 8 all required pericardial drainage (some with temporary pericardial drain left in place) for both diagnosis and therapeutics. Additionally, all were medically managed with antibiotics of varying lengths (range: 2-8 weeks) and routes (oral/intravenous [IV]/combination).…”

Section: Discussionmentioning

confidence: 99%

“…Among those with reported follow-up, no patients had reaccumulation of pericardial effusion or complications such as constrictive pericarditis. One case was complicated by mycotic pseudoaneurysm formation and resultant compression on the pulmonary vasculature, 5 which occurred several days after pericardiocentesis. One older study showed that early intervention for purulent pericarditis 10 with pericardiectomy should be done if patient has tamponade after initial pericardiocentesis or if fever persists while on appropriate antibiotics.…”

Section: Discussionmentioning

confidence: 99%

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Surgical and Medical Management of Purulent Bacterial Pericarditis With Pericardial Mass in a Young Child

et al. 2023

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surgical and Medical Management of Purulent Bacterial Pericarditis With Pericardial Mass in a Young Child

et al. 2023

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Kaposiform lymphangiomatosis presenting with a Group AStreptococcuspericardial effusion

et al. 2022

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A 4-year-old child was transferred to the paediatric intensive care unit with acute respiratory failure following 4 days of fever, nausea and vomiting. Chest X-ray on admission had an enlarged cardiac silhouette and transthoracic echo confirmed a large pericardial effusion. An emergent pericardiocentesis was performed at bedside which drained nearly 1000 mL of purulent fluid. Postdrainage course was complicated by acute systolic and diastolic heart failure, thrombocytopenia and acute renal failure. A chest CT and MRI were concerning for a diffuse mediastinal soft-tissue density, so the patient underwent interventional radiology-guided biopsy complicated by haemorrhage requiring mediastinal exploration and subtotal thymectomy. Histopathology revealed changes consistent with kaposiform lymphangiomatosis and MRI demonstrated involvement of the lumbar spine and right hip. Following a course of intravenous antibiotics, the patient was started on sirolimus and prednisolone and ultimately discharged home.

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The “Old yet New” Echocardiographic Finding for Constrictive Pericarditis Following Purulent Pericarditis: A Case Report

Sudo

2024

Cureus

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Purulent pericarditis (PP) is a localized infection of the pericardial cavity with suppuration that can be life-threatening. Treatment for PP consists of pericardial drainage and antimicrobial therapy. Constrictive pericarditis (CP), a form of diastolic heart failure that arises because an inelastic thickened pericardium, is a possible related dreadful complication of PP. Several echocardiographic findings suggestive of CP have been reported, but some require measurements or are difficult to reproduce. This case report presents a simple echocardiographic finding that reflects the clinical course of transient CP (TCP). A 76-year-old Japanese man presented to our hospital with chest pain and dyspnea. He was diagnosed with PP caused by Streptococcus pyogenes and treated with pericardial drainage and benzylpenicillin. The response to the treatment of the infection was favorable, but subsequent echocardiography and cardiac catheterization revealed a CP complication. Treatment with colchicine and ibuprofen was initiated, with improvement in CP within three months. During CP, a restricted right ventricular (RV) motion and movement of the liver towards the heart were observed before other echocardiographic findings suggestive of CP. Furthermore, this echocardiographic finding disappeared and normalized as CP improved. In this case of TCP following PP, changes in the echocardiographic “RV sliding” sensitively reflected the clinical course of CP. This simple finding may indicate inflammation of the pericardium and could be useful for the diagnosis and follow-up of CP.

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Streptococcus pyogenesPericarditis with Resultant Pulmonary Trunk Compression Secondary to Mycotic Pseudoaneurysm

Cited by 4 publications

References 19 publications

Surgical and Medical Management of Purulent Bacterial Pericarditis With Pericardial Mass in a Young Child

Surgical and Medical Management of Purulent Bacterial Pericarditis With Pericardial Mass in a Young Child

Kaposiform lymphangiomatosis presenting with a Group AStreptococcuspericardial effusion

The “Old yet New” Echocardiographic Finding for Constrictive Pericarditis Following Purulent Pericarditis: A Case Report

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