Wada Akira, Craft Jason, Mazzaferri Ernest L
Department of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
Cardiol Res. 2014 Dec;5(6):188-190. doi: 10.14740/cr356w. Epub 2014 Dec 4.
We report a case of a previously healthy 61-year-old immunocompetent male who was found to have purulent bacterial pericarditis. The patient was initially diagnosed with pneumococcal pneumonia and bacteremia after presenting with chest pain and a productive cough. He was found to have a purulent pericardial effusion and underwent surgical washout and creation of a pericardial window. In short time he developed signs of right heart failure and a cardiac MRI revealed a severely thickened pericardium with evidence of constrictive pericarditis. The patient subsequently underwent pericardiectomy where the diagnosis of constriction was confirmed. Our patient recovered well and had no clinical evidence of heart failure on follow-up. This case demonstrates the importance of rapid identification of bacterial pericarditis and the high likelihood of progression to constriction.
我们报告一例既往健康的61岁免疫功能正常男性，被发现患有化脓性细菌性心包炎。该患者最初因胸痛和咳痰而被诊断为肺炎球菌肺炎和菌血症。他被发现有脓性心包积液，并接受了手术冲洗和心包开窗术。短期内他出现了右心衰竭的症状，心脏磁共振成像显示心包严重增厚，有缩窄性心包炎的证据。患者随后接受了心包切除术，术中证实了缩窄的诊断。我们的患者恢复良好，随访时无心力衰竭的临床证据。该病例表明快速识别细菌性心包炎的重要性以及进展为缩窄的高可能性。
