Institute of Medical Microbiology and Hygiene, University Medical Centre Freiburg, 79104 Freiburg, Germany.
Department of Clinical Cardiology I, Heart Center Freiburg University, 79189 Bad Krozingen, Germany.
J Med Microbiol. 2014 Feb;63(Pt 2):313-316. doi: 10.1099/jmm.0.066290-0. Epub 2013 Nov 15.
Purulent pericarditis is a life-threatening disease that usually manifests following bacteraemia or through spreading from an intrathoracic focus. Only a few cases of this disease have been reported with Lancefield group C streptococci as aetiological agents, and the primary focus in these infections remains unknown. We report a case of purulent pericarditis with septic and cardiogenic shock, caused by Streptococcus equi subsp. zooepidemicus (group C) in a 51-year-old patient. The pathogen was possibly contracted through contact with horses. Most probably, it caused initially pneumonia before spreading to the pericardium, either directly or via the bloodstream. A combined therapeutic approach, consisting of antibiotic therapy and repeated pericardial drainage, was necessary to ensure a clinical cure. After discharge, long-term follow-up for development of constrictive pericarditis is considered mandatory.
化脓性心包炎是一种危及生命的疾病，通常在菌血症或通过从胸内病灶扩散后出现。只有少数化脓性心包炎病例被报道为乙型溶血性链球菌作为病因，而这些感染的原发灶仍不清楚。我们报告了一例由马链球菌兽疫亚种（C 组）引起的化脓性心包炎合并感染性和心源性休克，患者为 51 岁男性。病原体可能通过与马接触而感染。极有可能，它首先引起肺炎，然后通过直接或血流扩散至心包。需要采用抗生素治疗和反复心包引流的联合治疗方法，以确保临床治愈。出院后，应考虑进行长期随访，以观察是否发生缩窄性心包炎。
