Key result
A 4-year-old boy with acute osteomyelitis and pyopericardium complicated by cardiac tamponade improved significantly after receiving anti-tuberculosis therapy despite initial isolation of S. aureus.
Case Report (n=1)
No
In resource-limited settings, pyopericardium may present a diagnostic challenge due to coinfection, and empiric anti-tuberculosis therapy can be life-saving when clinical response to standard antibiotics is poor.
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May support empiric TB therapy in refractory pediatric pyopericardium despite S. aureus isolation; hypothesis-generating for coinfection, requiring prospective validation.
In pyopericardium, pus accumulates in the pericardial space as a result of infection by pyogenic organisms, most common of which are Staphylococcus aureus and Mycobacterium tuberculosis. These patients are at risk of cardiac tamponade. Apart from pericardiocentesis in the management of these patients, definitive drug treatment may pose a formidable challenge in a setting of coinfection as in patients with tuberculosis who are predisposed to secondary bacterial infections. This was the case of our patient. We here highlight the challenges faced with etiologic diagnosis in resource-limited settings.
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Peter et al. (2017) conducted a case report in Pyopericardium with cardiac tamponade and acute osteomyelitis (n=1). Anti-tuberculosis therapy and pericardiocentesis was evaluated on Clinical improvement. A 4-year-old boy with acute osteomyelitis and pyopericardium complicated by cardiac tamponade improved significantly after receiving anti-tuberculosis therapy despite initial isolation of S. aureus.
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