Key result
A 61-year-old male with purulent bacterial pericarditis rapidly progressed to constrictive pericarditis, which was successfully treated with pericardiectomy resulting in complete clinical recovery.
Case Report (n=1)
No
This case demonstrates the importance of rapid identification of bacterial pericarditis and the high likelihood of progression to constrictive pericarditis requiring pericardiectomy.
Clinicians should monitor purulent pericarditis for rapid constriction; Level 5 evidence leaves optimal pericardiectomy timing open.
We report a case of a previously healthy 61-year-old immunocompetent male who was found to have purulent bacterial pericarditis. The patient was initially diagnosed with pneumococcal pneumonia and bacteremia after presenting with chest pain and a productive cough. He was found to have a purulent pericardial effusion and underwent surgical washout and creation of a pericardial window. In short time he developed signs of right heart failure and a cardiac MRI revealed a severely thickened pericardium with evidence of constrictive pericarditis. The patient subsequently underwent pericardiectomy where the diagnosis of constriction was confirmed. Our patient recovered well and had no clinical evidence of heart failure on follow-up. This case demonstrates the importance of rapid identification of bacterial pericarditis and the high likelihood of progression to constriction.
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Wada et al. (2014) conducted a case report in Purulent bacterial pericarditis (n=1). Pericardiectomy was evaluated on Clinical recovery. A 61-year-old male with purulent bacterial pericarditis rapidly progressed to constrictive pericarditis, which was successfully treated with pericardiectomy resulting in complete clinical recovery.
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