Purulent pericarditis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Purulent pericarditis
File:Pericardial effusion with tamponade.gif
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Chest pain, fever, dyspnea
Complications	Cardiac tamponade, constrictive pericarditis
Onset	Sudden
Duration	Variable
Types	N/A
Causes	Bacterial infection
Risks	Immunosuppression, chronic kidney disease, alcoholism
Diagnosis	Echocardiogram, pericardial fluid analysis
Differential diagnosis	Tuberculous pericarditis, viral pericarditis
Prevention	N/A
Treatment	Antibiotics, pericardiocentesis, surgical drainage
Medication	N/A
Prognosis	Variable, depends on promptness of treatment
Frequency	Rare
Deaths	N/A

A type of pericarditis characterized by pus accumulation in the pericardial cavity

Purulent pericarditis is a severe form of pericarditis characterized by the accumulation of pus in the pericardial cavity. This condition is often associated with bacterial infections and can lead to serious complications if not treated promptly.

Pathophysiology

Purulent pericarditis occurs when bacteria invade the pericardial space, leading to an inflammatory response. The accumulation of pus results from the body's immune response to the infection. Common causative organisms include Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae. The infection can spread to the pericardium from adjacent structures, such as the lungs, or through the bloodstream.

Clinical Presentation

Patients with purulent pericarditis often present with symptoms of severe chest pain, fever, and dyspnea. The chest pain is typically sharp and may worsen with deep breathing or lying flat. Other symptoms may include tachycardia and signs of systemic infection.

Diagnosis

The diagnosis of purulent pericarditis is based on clinical presentation, imaging studies, and laboratory tests. Echocardiography is a key diagnostic tool that can reveal pericardial effusion and signs of cardiac tamponade. ECG changes may also be present, showing diffuse ST-segment elevation and PR-segment depression.

ECG changes in pericarditis

Complications

If left untreated, purulent pericarditis can lead to serious complications such as cardiac tamponade, constrictive pericarditis, and sepsis. Cardiac tamponade occurs when the pressure from the accumulated pus impairs the heart's ability to pump effectively.

Treatment

The primary treatment for purulent pericarditis involves antibiotics to target the underlying bacterial infection. Empirical broad-spectrum antibiotics are often initiated until specific culture results are available. In addition to antibiotics, drainage of the purulent material is crucial. This can be achieved through procedures such as pericardiocentesis or surgical drainage.

Pericardiocentesis procedure

Prognosis

The prognosis of purulent pericarditis depends on the timeliness of diagnosis and treatment. With prompt and appropriate management, the outcome can be favorable. However, delays in treatment can lead to significant morbidity and mortality.

Prevention

Preventive measures include timely treatment of bacterial infections and vaccination against common pathogens such as Streptococcus pneumoniae and Haemophilus influenzae.

See also

• Pericarditis
• Cardiac tamponade
• Constrictive pericarditis