Key result
A 17-year-old boy with mediastinal tuberculous lymphadenitis developed polymicrobial purulent pericarditis, likely due to a broncho-lymph node-pericardial fistula, and successfully recovered following pericardiectomy and targeted antimicrobial therapy.
Case Report (n=1)
This case highlights that polymicrobial purulent pericarditis can occur as a rare complication of mediastinal tuberculous lymphadenitis via a broncho-lymph node-pericardial fistula, requiring combined antimicrobial therapy and pericardiectomy.
May prompt vigilance for fistulous spread in mediastinal TB with purulent pericarditis; case report leaves open optimal management strategies.
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.
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Lee et al. (2015) conducted a case report in Polymicrobial purulent pericarditis and tuberculous lymphadenitis (n=1). Pericardiectomy and antimicrobial therapy was evaluated on Clinical recovery. A 17-year-old boy with mediastinal tuberculous lymphadenitis developed polymicrobial purulent pericarditis, likely due to a broncho-lymph node-pericardial fistula, and successfully recovered following pericardiectomy and targeted antimicrobial therapy.
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