Ali Mo'ath Bani, Hakemi Emad, Al Badarin Firas, Khalil Adam M, Alhmouz Musa'ab M, Bany Ata Rami H, Saeid Alaa J, Smer Aiman, Khalil Mohammed E
Cleveland Clinic, Abu Dhabi, United Arab Emirates.
Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar.
JACC Case Rep. 2025 Jul 23;30(20):104180. doi: 10.1016/j.jaccas.2025.104180.
Septic pericarditis is a rare but life-threatening condition that can mimic acute coronary syndrome (ACS).
A 45-year-old man with diabetes and hypertension presented with acute chest pain and hypotension. Initial electrocardiogram raised suspicion for ACS; however, coronary angiography showed no coronary artery disease. The patient subsequently developed a rapidly progressive pericardial effusion and cardiac tamponade, necessitating urgent pericardiocentesis. Drained pericardial fluid was purulent and cultures confirmed Neisseria meningitidis infection. The patient received systemic antibiotics and continued drainage of pericardial fluid, resulting in complete recovery.
This case highlights the importance of considering infectious etiologies like N meningitidis in patients presenting with symptoms resembling ACS. Literature indicates that hyperinvasive strains of N meningitidis can cause severe cardiac complications, making awareness crucial for timely diagnosis and treatment.
TAKE-HOME MESSAGES: N meningitidis can present with septic pericarditis mimicking ACS. Prompt recognition and multidisciplinary management are essential for favorable outcomes.
化脓性心包炎是一种罕见但危及生命的疾病,可类似急性冠状动脉综合征(ACS)。
一名患有糖尿病和高血压的45岁男性出现急性胸痛和低血压。初始心电图引发了对ACS的怀疑;然而,冠状动脉造影显示无冠状动脉疾病。该患者随后出现快速进展的心包积液和心脏压塞,需要紧急心包穿刺术。引流的心包液为脓性,培养证实为脑膜炎奈瑟菌感染。患者接受了全身抗生素治疗并持续引流心包液,最终完全康复。
该病例强调了在表现出类似ACS症状的患者中考虑如脑膜炎奈瑟菌等感染病因的重要性。文献表明,脑膜炎奈瑟菌的高侵袭性菌株可导致严重的心脏并发症,因此提高认识对于及时诊断和治疗至关重要。
脑膜炎奈瑟菌可表现为类似ACS的化脓性心包炎。迅速识别和多学科管理对于取得良好结果至关重要。