Interv Akut Kardiol. 2007;6(5):192-194

Purulent pericarditis with cardiac tamponade

David Vindiš¹, Pavel Třeštík², Petr Němec³, Hana Študentová²

¹ I. interní klinika FN a LF UP Olomouc

² Kardiochirurgická klinika FN a LF UP v Olomouci

³ Centrum kardiovaskulární a transplantační chirurgie v Brně

Purulent pericarditis is a rare disease, often remarked as a complication of an infection originating elswhere in the body. The course of the disease is typically fulminant (often with evolving of cardiac tamponade), with high mortality rate (100 % in untreated patients, around 40 % in treated patients). Early diagnosing of this condition is important. The treatment is based on targeted antibiotic therapy and pericardiocentesis. If this approach is ineffective, surgical pericardial fenestration with drainage is needed.

The case report describes purulent pericarditis in a 73-year-old man with onset of cardiac tamponade in the course of hospitalization. Pericardiocentesis was performed urgently to evacuate purulent exudate, antibiotic therapy was initiated. Due to persistent clinical signs of effusion and hemodynamic instability, fenestration of the pericardium with destruction of pericardial septa and drainage was performed. The subsequent hospitalization leads to clinical stabilization allowing discharge from the hospital 36 days after the onset of the disease.

Keywords: purulent pericarditis, cardiac tamponade, pericardiocentesis, fenestration of the pericardium

Published: January 16, 2008  Show citation