Department of Medicine, Faculty of Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
Department of Medicine, Clinic of Internal Diseases, Lithuanian University of Health Sciences, 47144 Kaunas, Lithuania.
Medicina (Kaunas). 2020 Oct 29;56(11):571. doi: 10.3390/medicina56110571.
Erysipelas is a common skin infection of the upper dermis. Its most common complications are local; these include abscess formation, skin necrosis, etc. In the present article, we introduce a case of a 75-year-old patient with erysipelas of the face complicated with acute exudative pericarditis. The patient came to Kaunas Clinical Hospital complaining of extreme fatigue and fever, oedema of the left side of the face, and erythema typical for erysipelas. The patient also felt sternum and epigastric pain, especially during breathing, and dyspnoea. Heart work was rhythmic 100 bpm; blood pressure was 142/70 mmHg. Pericardial friction rub was heard over the left sternal border. There were no alterations in other systems. In the electrocardiogram, concave ST segment elevation in leads II, III, and aVF was identified. In addition, during hospitalisation, the patient experienced atrial fibrillation paroxysm, which was treated with amiodarone intravenously. The blood test showed C-reactive protein: 286 mg/L; white blood cells: 20 × 10/L; troponin I was within the normal range. During echocardiography, pericardial fluid in pericardial cavity was identified. As no changes in troponin I were observed, according to the ST segment elevation, the woman was diagnosed with erysipelas of the left side of the face complicated with acute exudative pericarditis. Antibacterial treatment of cephalosporins was administered. After the treatment, C-reactive protein decreased to 27.8 mg/L; whereas, in the electrocardiogram, the return of the ST segment to the isoline was observed, and pericardial fluid resorbed from the pericardial cavity. To the best of the authors' knowledge, this case is a rare combination of erysipelas complicated with acute exudative pericarditis.
丹毒是一种常见的真皮上部皮肤感染。其最常见的并发症为局部并发症，包括脓肿形成、皮肤坏死等。本文介绍了 1 例 75 岁面部丹毒并发急性渗出性心包炎的患者。该患者因极度疲劳和发热、左侧面部水肿和典型的丹毒红斑来到考纳斯临床医院就诊。患者还感到胸骨和上腹部疼痛，尤其是在呼吸时，并伴有呼吸困难。心脏节律为 100 次/分；血压为 142/70mmHg。在胸骨左缘可闻及心包摩擦音。其他系统无改变。心电图显示 II、III、aVF 导联 ST 段凹面抬高。此外，在住院期间，患者出现心房颤动发作，用胺碘酮静脉治疗。血液检查显示 C 反应蛋白：286mg/L；白细胞：20×10/L；肌钙蛋白 I 在正常范围内。在超声心动图检查中，发现心包腔内有心包积液。由于肌钙蛋白 I 无变化，根据 ST 段抬高，该女性被诊断为左侧面部丹毒并发急性渗出性心包炎。给予头孢菌素抗菌治疗。治疗后，C 反应蛋白降至 27.8mg/L；而在心电图上，ST 段回到等电线，心包腔内的心包积液被吸收。据作者所知，这种情况是丹毒并发急性渗出性心包炎的罕见组合。
