Key result
Open pericardiectomy with lavage resolves acute constrictive physiology following rapid purulent pericarditis.
Why the study?
Constrictive pericarditis typically follows a chronic course, making rapidly progressing acute cases following purulent pericarditis rare and clinically important to describe.
Case Report (n=1)
Purulent pericarditis can rapidly progress to constrictive pericarditis within days, necessitating early recognition and prompt surgical pericardiectomy even in the absence of classical imaging findings.
Answers are grounded in this paper and cite their sources.
May alert to rapid constriction after purulent pericarditis; hypothesis-generating case leaves open optimal timing for pericardiectomy.
Constrictive pericarditis (CP) typically develops after a chronic course of infection or other etiologies. We report a rare case of acute CP that manifested rapidly following purulent pericarditis (PP). A 63-year-old woman with a history of hematologic disease presented with dyspnea and fever. Pericardial effusion with signs of infection was noted, and emergency pericardial drainage was performed because of hemodynamic instability. Haemophilus influenzae was detected in the pericardial fluid; consequently, antibiotic therapy was initiated. However, the patient’s condition deteriorated. Transthoracic echocardiography revealed diastolic dysfunction, leading to the diagnosis of acute CP on hospital day 10 after pericardiocentesis. Given the progressive hemodynamic compromise and treatment failure, open pericardiectomy with pericardial lavage was performed, resulting in rapid improvement in hemodynamics. The patient was discharged ambulatory on postoperative day 28. Although rare, PP can rapidly progress to CP; therefore, early surgical intervention should be considered in cases that do not respond to antibiotic therapy or pericardial drainage.
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Hayashi et al. (2026) conducted a case report in Purulent pericarditis progressing to constrictive pericarditis (n=1). Open pericardiectomy with pericardial lavage was evaluated on Resolution of restrictive physiology and hemodynamic improvement. Open pericardiectomy with pericardial lavage successfully treated a rare case of rapidly progressive constrictive pericarditis that developed within 10 days of purulent pericarditis onset.
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