Concomitant Purulent Pericarditis and Pleuritis Due to Actinomyces odontolyticus Following Endobronchial Biopsy for Pulmonary Sarcoidosis

Figures

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  Figure 1. Baseline and Current Chest Computed Tomography Scan (A) Baseline chest computed tomography 6 years before the current presentation. This study was performed to further evaluate incidentally found pulmonary nodules on routine pre-employment screening chest radiographs. Arrows = pulmonary nodules. (B) Current presentation chest computed tomography with contrast showing no signs of pulmonary embolism; however, there are multiple pulmonary nodules and a new pericardial effusion. Asterisk = right ventricle; double asterisks = left ventricle; and arrows = pericardial effusion.

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  Figure 2. Electrocardiographic Signs of Pericarditis Electrocardiographic images showing diffuse ST-segment elevation and PR-segment depression resembling electrocardiographic signs of pericarditis.

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  Figure 3. Echocardiographic Signs of Cardiac Tamponade (A) Parasternal long-axis (PLAX) view revealing circumferential pericardial effusion; (B) short-axis; (C) apical 4-chamber; (D) apical 2-chamber; (E) subcostal view; (F) pulse-wave Doppler of transmitral diastolic flow reveals >40% respiratory variation; (G) M-mode in the parasternal long-axis showing early right ventricle (RV) diastolic collapse (arrow); (H) plethoric inferior vena cava measuring 2.3 cm without collapse during respiration. The asterisk indicates pericardial effusion.