Purulent pericarditis

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Purulent pericarditis
Purulent pericarditis
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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

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

See also[edit | edit source]

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Contributors: Prab R. Tumpati, MD