Highlights the possibility of afebrile bacterial pericarditis in cancer patients with pericardial effusions, emphasizing the need for both cultures and cytology.
Clinicians should consider infection in afebrile cancer patients with pericardial effusion; this case leaves open whether routine dual analysis changes practice.
Pneumococcal pericarditis complicated by a malignant effusion has not been reported previously. We experienced an independent 62-year-old man with lung cancer who was hospitalized for acute onset of atrial flutter and moderate pericardial effusion. He was afebrile; however, pericardiocentesis showed Streptococcus pneumoniae and malignant squamous cells in purulent pericardial fluid. This case shows that clinicians should keep in mind the possibility of afebrile bacterial pericarditis in cancer patients with pericardial effusions and that cultures of pericardial fluid should be performed in such patients along with cytological examinations.
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Nakazawa et al. (2013) studied this question.
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