Bacterial pericarditis in a cat

Abstract

Case summaryA 4-year-old male neutered domestic shorthair cat was presented to the Oregon State University cardiology service for suspected pericardial effusion. Cardiac tamponade was documented and pericardiocentesis yielded purulent fluid with cytologic results supportive of bacterial pericarditis. The microbial population consisted of Pasteurella multocida, Actinomyces canis, Fusobacterium and Bacteroides species. Conservative management was elected consisting of intravenous antibiotic therapy with ampicillin sodium/sulbactam sodium and metronidazole for 48 h followed by 4 weeks of oral antibiotics. Re-examination 3 months after the initial incident indicated no recurrence of effusion and the cat remained free of clinical signs 2 years after presentation.Relevance and novel informationBacterial pericarditis is a rare cause of pericardial effusion in cats. Growth of P multocida, A canis, Fusobacterium and Bacteroides species has not previously been documented in feline septic pericarditis. Conservative management with broad-spectrum antibiotics may be considered when further diagnostic imaging or exploratory surgery to search for a primary nidus of infection is not feasible or elected.

Septic pericardial disease and mediastinal abscessation in a cat with an intrathoracic needle foreign body

“…Pericardial actinomycosis has been reported in the human literature, with the majority of cases spreading to the pericardium directly from a thoracopulmonary site 21,22 . A feline case reported Actinomyces canis isolated via culture of pericardial effusion as part of a mixed infection, without an identified foreign body 11 . The isolation of an Actinomyces species in the present cat, with a documented, migrating, intrathoracic foreign body, emphasizes the importance of both aerobic and anaerobic bacterial culture.…”

“…21,22 A feline case reported Actinomyces canis isolated via culture of pericardial effusion as part of a mixed infection, without an identified foreign body. 11 The isolation of an Actinomyces species in the present cat, with a documented, migrating, intrathoracic foreign body, emphasizes the importance of both aerobic and anaerobic bacterial culture. Diagnostics for other organisms-toxoplasmosis, fungal, viralwere not performed in the present case but may be considered in select patients.…”

“…10 Three separate cases were successfully managed with pericardiocentesis and medical management only. 8,9,11 A cat with fibrinous bacterial pericarditis that died with medical management only has been reported; the authors of that report suggested that surgical management is indicated for these cases. 18 None of these reported cats had a documented intrathoracic foreign body; thoracotomy was considered necessary in the current case for foreign body removal and debridement of the mediastinal abscesses.…”

“…One case of septic pericardial disease reported successful management via pericardiectomy; a median sternotomy was used concurrent with midline laparotomy for emergency ovariohysterectomy 10 . Three separate cases were successfully managed with pericardiocentesis and medical management only 8,9,11 . A cat with fibrinous bacterial pericarditis that died with medical management only has been reported; the authors of that report suggested that surgical management is indicated for these cases 18 .…”

“…Septic pericardial disease in cats has been reported concurrent with peritonitis, pneumonia, skeletal muscle abscessation, septicemia, periodontal infection, and pyometra. 4,5,[9][10][11] Idiopathic septic pericardial disease has also been described. 8 Penetrating thoracic wounds and intrathoracic foreign bodies have been proposed as the cause of septic pericardial effusion in cats, but neither has been definitively identified.…”