Evron E, Goland S, Somin M, Sthoeger Z M
Dept. of Medicine C, Kaplan Hospital, Rehovot.
Harefuah. 1996 May 1;130(9):602-3, 655.
Purulent pericarditis is diagnosed when pus is drained from the pericardial space or when bacteria are cultured from the pericardial fluid. This rare disease is often diagnosed late, when severe hemodynamic compromise develops due to pericardial tamponade. It is usually a complication of pneumonia, especially if there is empyema as well, and often follows chest surgery or chest wall infections. It sometimes appears in patients with septicemia, especially when they are debilitated or immuno-compromised. Diagnosis is aided by echocardiography. Pericardiocentesis and drainage of the pus, as well as prolonged antibiotic treatment, are mandatory. Delay in diagnosis and treatment often results in death. Some surviving patients may develop constrictive pericarditis and require pericardiectomy. We report a 73-year-old man with pulmonary lymphoma who suffered from purulent pericarditis secondary to sepsis with methicillin-resistant Staphylococcus aureus. Pericardial drainage and appropriate antibiotic treatment eventually resulted in complete recovery.
当从心包腔引流到脓液或从心包液中培养出细菌时，即可诊断为化脓性心包炎。这种罕见疾病往往在出现严重血流动力学障碍（因心包填塞所致）时才被诊断出来，通常诊断较晚。它通常是肺炎的并发症，尤其是伴有脓胸时，且常继发于胸部手术或胸壁感染之后。有时也会出现在败血症患者中，特别是那些身体虚弱或免疫功能低下者。超声心动图有助于诊断。心包穿刺抽脓及引流，以及长期抗生素治疗是必不可少的。诊断和治疗的延误常导致死亡。一些存活患者可能会发展为缩窄性心包炎，需要进行心包切除术。我们报告了一名73岁患有肺淋巴瘤的男性患者，他因耐甲氧西林金黄色葡萄球菌败血症继发化脓性心包炎。心包引流及适当的抗生素治疗最终使其完全康复。
