Indolent Purulent Pericarditis Due to Viridans Streptococcus Infection Successfully Treated by Pericardiocentesis and Penicillin G

Chung-Ming Tu ； Shu-Meng Cheng ； Shih-Ping Yang ； Tsorng-Liu Hsieh ； Shyi-Shiaw Jiau

《Acta Cardiologica Sinica》 24卷2期 (2008/06) Pp. 113-116

並列摘要

Although purulent pericarditis generally presents with acute cardiovascular decompensation and a sepsis-like appearance, it can be indolent in rare settings, leading to a catastrophic outcome. We report a 77-year-old female who presented with progressive dyspnea without fever. Massive pericardial effusion with cardiac tamponade was detected by the transthoracic echocardiogram. The fluid culture yielded Viridans Streptococcus which was susceptible to penicillin G. The patient dramatically improved after 14 days' penicillin G treatment and did well during the 10 months' follow-up. Purulent pericardial effusion should be kept inmind as a lethal cause of cardiac tamponade, even in afebrile patients. Emergent pericardiocentesis followed by appropriate antibiotics treatment is essential to avoid delayed diagnosis and improper management

並列關鍵字

Cardiac tamponade ； Viridans Streptococcus ； Purulent pericarditis ； Gram stain