Polymicrobial Purulent Pericarditis Probably caused by a Broncho-Lymph Node-Pericardial Fistula in a Patient with Tuberculous Lymphadenitis

Abstract

Purulent pericarditis is a rare condition with a high mortality rate. We report a case of purulent pericarditis subsequently caused by Candida parapsilosis, Peptostreptococcus asaccharolyticus, Streptococcus anginosus, Staphylococcus aureus, Prevotella oralis, and Mycobacterium tuberculosis in a previously healthy 17-year-old boy with mediastinal tuberculous lymphadenitis. The probable route of infection was a bronchomediastinal lymph node-pericardial fistula. The patient improved with antibiotic, antifungal, and antituberculous medication in addition to pericardiectomy.

Candida pericarditis presenting with cardiac tamponade and multiple organ failure after combined damage control thoracotomy and laparotomy with splenectomy in a trauma patient: Case report and review of literature

“… Etiology Age Gender Species Surgical Management Therapy Time Frame Ref. Chemotherapy/radiation for gastric adenocarcinoma/esophagojejunostomy 54 M albicans Pericardiocentesis Caspofungin 5–2 months 18 Total esophagectomy with gastric pull-up for esophageal cancer 66 M tropicalis Pericardiectomy/epicardiectomy Not reported 6 years 42 Left ventricular dacron patch repair for ventricular rupture 61 M albicans Left thoracotomy with pericardial fenestration and Latissimus dorsi flap over patch Fluconazole 149 days 47 Esophago-pericardial fistula in heavy alcoholic 43 M albicans Pericardiocentesis Fluconazole Unknown 41 Esophagectomy with colonic interposition (atresia) 42 F albicans Sternotomy drainage Caspofungin 40 years 19 Tuberculous broncho-pericardial Fistula 17 M parapsilosis Pericardiectomy Fluconazole 1 month 20 Neonatal endocarditis 14 days F albicans None Fluconazole/amphotericin B 2 days 49 Pneumonia/ARDS history of IV drug abuse 57 M glabrata Pericardial drain placement Voriconazole Unknown 53 Spontaneous pericarditis 38 M al...…”

“…Candida pericarditis is a high mortality condition if not recognized and treated on time [5] , [8] , [18] , [19] , [20] , [21] , [22] , [23] . Due to the tendency of pericarditis to occur later in the hospitalization timeline and resulting in devastating consequences on patients that already have used extensive amounts of medical resources, it is essential to effectively identify the condition and rapidly formulate an action plan.…”

Septic Shock, Renal Abscess, and Bacteremia Due to Peptoniphilus asaccharolyticus in a Woman with Nephrosis and Diabetes Mellitus: Case Report and Literature Review

“… 3 Although rarely reported, Peptoniphilus species have been cultured from other clinical specimens, such as bone and joint specimens, pressure ulcer samples, vaginal discharges, blood, urine, spinal fluid, amniotic fluid, eye discharge, pericardial fluid, and various specimens of abscesses. 1–3 , 6–9 Currently, diseases associated with this group of reported infections include skin and soft tissue infections, 2 bone and joint infections (including prosthetic joint infections), 7 arthritis and osteomyelitis, 6 bloodstream infections, 2 urinary tract infections, 8 pulmonary pneumatoceles, 10 peritonsillar abscess, 11 renal abscess, 12 bacterial vaginosis, 13 meningitis, 14 pericarditis, 9 scrotal abscess, 3 and spinal abscess. 3 Patients infected with the organisms are often elderly, immunocompromised, and post-surgical (particularly orthopedic surgery).…”

Pericarditis purulenta por Mycobacterium Tuberculosis y Streptococcus Pneumoniae. Revisión del tema, a propósito de un caso

“…Está descrita en relación a procedimientos quirúrgicos abdominales complicados, neoplasias del tracto digestivo, diabetes mellitus e infección por VIH. Se han aislado bacilos gram negativos y anaerobios en el líquido pericárdico de enfermos con fístulas pericardio-digestivas 6 . La asociación entre pericarditis purulenta y tuberculosis pericárdica es anecdótica.…”