Zoulati Ghizlane, Maïga Ramatou Yèya, Kerzaz Rachid, Yahyaoui Ghita, Harandou Mustapha, Mahmoud Mustapha
Service de microbiologie, Laboratoire central d'analyses médicales, CHU Hassan II, Fès, Maroc.
Service de réanimation maternelle et pédiatrique, CHU Hassan II, Fès, Maroc.
Ann Biol Clin (Paris). 2018 Jan 1;76(1):111-113. doi: 10.1684/abc.2017.1317.
Purulent pericarditis has become rare since the advent of antibiotics. Among the involved germs, S. pneumoniae remains the most implicated pathogen to evoke in principle, especially that prescription of systematic antibiotics for any febrile condition can considerably mask the clinical picture. A 36-year-old pregnant woman was visiting the emergency department for dyspnea and flu-like syndrom that had been going on for a week. The chest X-ray showed a white lung on the left and the transthoracic ultrasound revealed a pericardial effusion, resulting in pericardial drainage and pleural puncture that allows the evacuation of a purulent fluid. S. pneumoniae was identified on the pericardial fluid. Antibiotic therapy and resuscitation measures have allowed a good evolution. Even if it has become exceptional, pneumococcal pericarditis must not be overlooked since the evolution is often favorable in triple conditions: early recognition, prompt institution of appropriate antibiotic therapy, and early surgical drainage.
自抗生素问世以来,脓性心包炎已变得罕见。在相关病菌中,肺炎链球菌原则上仍是最常引发该病的病原体,尤其是对任何发热病症使用系统性抗生素治疗会极大地掩盖临床症状。一名36岁的孕妇因持续一周的呼吸困难和流感样综合征前往急诊科就诊。胸部X光显示左肺呈白色,经胸超声显示有心包积液,遂进行心包引流和胸腔穿刺,引出脓性液体。心包液中鉴定出肺炎链球菌。抗生素治疗和复苏措施使病情得到良好转归。尽管肺炎球菌性心包炎已变得罕见,但绝不能忽视,因为在具备以下三个条件时病情往往会向好发展:早期识别、及时给予适当的抗生素治疗以及早期手术引流。