Clinicians in HIV endemic areas should consider dual infection with S. pneumoniae and M. tuberculosis in patients with purulent pericarditis who respond inadequately to either antibiotics or anti-tuberculous therapy alone.
Case report of dual S. pneumoniae-M. tuberculosis pericarditis; hypothesis-generating for considering co-infection in refractory cases in endemic regions.
BACKGROUND: Both Mycobacterium tuberculosis and Streptococcus pneumoniae are common pathogens in patients with HIV infection. CASE PRESENTATION: We present an unusual case of purulent pericarditis resulting in cardiac tamponade due to infection with both organisms. We highlight the re-emergence of pneumococcal pericarditis in the HIV era and describe the pitfalls and challenges in the diagnosis of this condition. CONCLUSION: Clinicians working in HIV endemic areas need to consider dual infection with these organisms in patients who respond inadequately to either antibiotics or anti-tuberculous therapy alone.
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Louw et al. (2007) studied this question.
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