Background: Purulent pericarditis, a rare disease with a high associated mortality rate in patients without adequate treatment, can cause serious complications, such as perforation of the surrounding tissue and organs. is a very rare cause of purulent pericarditis.
Case Summary: A 70-year-old male patient presented to our emergency room with chest pain of 10 days' duration. An electrocardiogram showed ST-segment elevation and PR-segment depression on multiple leads. A transthoracic echocardiogram showed normal left ventricular function and a large amount of pericardial effusion. Acute pericarditis was diagnosed, and anti-inflammatory drug therapy was initiated. Due to the lack of improvement in the symptoms, pericardiocentesis was performed on Day 8 and revealed about 800 cc of the bloody fluid. was detected in a culture of the pericardial effusion and blood. Although intravenous antibiotic therapy was initiated for purulent pericarditis, his fever persisted. Computed tomography of the chest performed on Day 14 showed an abscess cavity in the pericardial space around the right atrium (RA). Furthermore, transoesophageal echocardiography revealed vegetation in the RA. Emergency surgery confirmed the presence of vegetation and minor perforation of the RA with communication to the abscess cavity. After surgical therapy, the patient clinically improved and was discharged on Day 51.
Discussion: In cases of acute pericarditis, purulent pericarditis should be considered if clinical improvement is not observed after initial treatment with anti-inflammatory drugs. Once the diagnosis of purulent pericarditis is made, aggressive source control is necessary for improved clinical outcomes.
Typhoid fever is a human-specific disease caused by subspecies of Salmonella enterica (Salmonella Typhi). It spreads through ingestion of contaminated food or water and is diagnosed through blood culture or bone marrow culture. It typically presents as an intestinal infection, with a few patients developing severe disseminated infections.
Purulent pericarditis is rare condition in the modern era of antibiotics. However, it is a serious condition as it has an accelerated progression and is difficult to diagnose due to its nonspecific clinical presentation, resulting in high mortality. Herein, we present a case in which a 36-year-old male patient with otherwise unremarkable medical history developed abdominal sepsis complicated by purulent pericarditis post-appendectomy.
Concomitant presentation of purulent pericarditis and mycotic pseudoaneurysm of the ascending aorta is exceedingly uncommon. We present a case of a 63-year-old male who presented to the emergency department after one week of severe neck pain along with pleuritic chest pain. He was found to have purulent pericarditis associated with a 0.
Pneumopericardium is an unusual condition defined by the presence of gas into the pericardial sac. Gastric perforation into pericardium is a complication of gastric ulcer with high mortality. In this clinical case, we describe the condition of a male with a silent gastric ulcer, which penetrated into the pericardium, developing pneumopericardium and purulent pericarditis as a complication.
