Streptococcus pneumoniae-associated pneumonia complicated by purulent pericarditis : case series
Cillóniz, Catia (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Rangel, Ernesto (Universidad Nacional Autónoma de México)
Barlascini, Cornelius (Servizio di Igiene e Sanità Pubblica, Ospedale Generale di Sestri Levante, Sestri Levante, Italia)
Piroddi, Ines Maria Grazia (Servizio di Pneumologia, Ospedale Generale di Sestri Levante, Sestri Levante, Italia)
Torres, Antoni (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Nicolini, Antonello (Servizio di Pneumologia, Ospedale Generale di Sestri Levante, Sestri Levante, Italia)

Date:	2015
Abstract:	In the antibiotic era, purulent pericarditis is a rare entity. However, there are still reports of cases of the disease, which is associated with high mortality, and most such cases are attributed to delayed diagnosis. Approximately 40-50% of all cases of purulent pericarditis are caused by Gram-positive bacteria, Streptococcus pneumoniae in particular. We report four cases of pneumococcal pneumonia complicated by pericarditis, with different clinical features and levels of severity. In three of the four cases, the main complication was cardiac tamponade. Microbiological screening (urinary antigen testing and pleural fluid culture) confirmed the diagnosis of severe pneumococcal pneumonia complicated by purulent pericarditis. In cases of pneumococcal pneumonia complicated by pericarditis, early diagnosis is of paramount importance to avoid severe hemodynamic compromise. The complications of acute pericarditis appear early in the clinical course of the infection. The most serious complications are cardiac tamponade and its consequences. Antibiotic therapy combined with pericardiocentesis drastically reduces the mortality associated with purulent pericarditis.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Pneumonia neumococcal-complications ; Pneumococcal-mortality ; Pericarditis-therapy ; Cardiac tamponade ; Streptococcus pneumoniae-pathogenicity
Published in:	Jornal Brasileiro de Pneumologia, Vol. 41 (2015) , p. 389-394, ISSN 1806-3756

DOI: 10.1590/S1806-37132015000000010
PMID: 26398760

6 p, 2.2 MB

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