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床旁超声心动图诊断阑尾切除术后化脓性心包炎:一例报告

Point-of-care ultrasonography for diagnosis of purulent pericarditis postappendectomy: a case report.

作者信息

Alexandre Neto José, Esposito Emanuel Pinheiro, Bastos Marcus Gomes, Araújo Cenilde da Costa, Ferreira Luan Moraes, Neves Apollo Vinícius Fernandes

机构信息

Faculdade de Medicina, Universidade do Estado do Pará, Santarém, PA, Brazil.

Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.

出版信息

Einstein (Sao Paulo). 2024 Dec 13;22:eRC0962. doi: 10.31744/einstein_journal/2024RC0962. eCollection 2024.

Abstract

Purulent pericarditis is rare condition in the modern era of antibiotics. However, it is a serious condition as it has an accelerated progression and is difficult to diagnose due to its nonspecific clinical presentation, resulting in high mortality. Herein, we present a case in which a 36-year-old male patient with otherwise unremarkable medical history developed abdominal sepsis complicated by purulent pericarditis post-appendectomy. While the initial clinical presentation was not compatible with the classic signs of purulent pericarditis, the diagnosis was made using electrocardiography (ST elevation/PR depression) and point-of-care ultrasonography (pericardial effusion). The condition was successfully managed with pericardial drainage and broad-spectrum antibiotics. The present case reinforces and reiterates the need for high diagnostic suspicion and careful clinical reasoning in the diagnosis of purulent pericarditis. Furthermore, it highlights the applicability of point-of-care ultrasonography in the diagnosis of the same.

摘要

在抗生素应用的现代时期,化脓性心包炎是一种罕见病症。然而,它是一种严重疾病,因为其进展迅速,且由于临床表现不具特异性而难以诊断,导致死亡率很高。在此,我们报告一例病例,一名36岁男性患者,既往病史无特殊,在阑尾切除术后发生腹部脓毒症并并发化脓性心包炎。虽然最初的临床表现与化脓性心包炎的典型体征不符,但通过心电图(ST段抬高/PR段压低)和即时超声心动图(心包积液)做出了诊断。通过心包引流和广谱抗生素成功治疗了该病症。本病例强化并再次强调了在诊断化脓性心包炎时需要高度的诊断怀疑和仔细的临床推理。此外,它突出了即时超声心动图在该病诊断中的适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6163/11634327/ebe10da627d0/2317-6385-eins-22-eRC0962-gf01.jpg

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