Hussein Abdinafic Mohamud, Ucaroglu Erhan Renan, Hassan Dirie Abdirahman Mohamed, Yusuf Mohamed Farah, Osman Abdirahman Abdulkadir
Department of Cardiovascular Surgery, Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia.
Department of Pulmonology, Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia.
Ann Med Surg (Lond). 2022 Mar 12;76:103502. doi: 10.1016/j.amsu.2022.103502. eCollection 2022 Apr.
Localized staphylococcal pericardial abscess (PA) is extremely rare and highly mortal complication of Staphylococcus aureus bacteremia with only a few reported cases in English-language medical literature. Clinical manifestations are fulminant, and early management is necessary.
Here we report a case of end stage renal disease (ESRD) with isolated localized massive staphylococcal PA and had masked signs and symptoms of pericardial staphylococcal infection. Contrast-enhanced computed tomography scan suggested anterior massive localized pericardial cyst like image. Surgical drainage of the abscess with localized pericardiectomy conjugated with antibiotic therapy led to a successful management.
Staphylococcus aureus is the leading cause of hemodialysis catheter-related bloodstream infections, contributing 33-80% of the organisms cultured from blood samples. Nature of staphylococcal pericardial infection is aggressive and life threatening with generalized involvement of the pericardium although our patient presented with masked signs and symptoms.
CT image of localized pericardial lesion with masked signs and symptoms does not exclude the presence of live threating pericardial infection, especially in immunocompromised patients.
局限性葡萄球菌心包脓肿（PA）是金黄色葡萄球菌菌血症极其罕见且死亡率很高的并发症，英文医学文献中仅有少数病例报道。临床表现凶险，早期处理很有必要。
在此我们报告一例终末期肾病（ESRD）患者，其患有孤立性局限性巨大葡萄球菌心包脓肿，心包葡萄球菌感染的体征和症状不明显。增强计算机断层扫描显示前侧巨大局限性心包囊肿样影像。脓肿手术引流并局部心包切除术联合抗生素治疗取得了成功。
金黄色葡萄球菌是血液透析导管相关血流感染的主要原因，在血培养分离出的微生物中占33% - 80%。葡萄球菌心包感染的性质具有侵袭性且危及生命，可导致心包广泛受累，尽管我们的患者体征和症状不明显。
有不明显体征和症状的局限性心包病变的CT影像不能排除存在危及生命的心包感染，尤其是在免疫功能低下的患者中。
