Massive purulent pericarditis presenting as cardiac tamponade

Report of a Fatal Purulent Pericarditis Case Caused by ST11-K64 Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae

“…1 Purulent pericarditis more frequently occurs in populations with compromised immune function or other predisposing factors such as diabetes and drug or alcohol abuse. 2 It is a rare disease but has a very poor prognosis, requiring life-saving early diagnosis and effective treatment. 2 Acute purulent pericarditis can rapidly progress into cardiac tamponade, systemic toxicity and cardiac diastolic dysfunction that lead to almost 100% mortality if left untreated and 40% in treated patients.…”

“…2 It is a rare disease but has a very poor prognosis, requiring life-saving early diagnosis and effective treatment. 2 Acute purulent pericarditis can rapidly progress into cardiac tamponade, systemic toxicity and cardiac diastolic dysfunction that lead to almost 100% mortality if left untreated and 40% in treated patients. 3 The sources of the infection are often non-cardiac but via systemic dissemination from a primary pulmonary or abdominal infection.…”

“…3 The sources of the infection are often non-cardiac but via systemic dissemination from a primary pulmonary or abdominal infection. In recent years, the ascendancy of pathogens causing purulent pericarditis tends to drift from the Gram-positive bacteria such as Streptococcus pneumonia and Staphylococcus aureus, 1 to Gram-negative bacteria such as Proteus, Escherichia coli, Pseudomonas, and in rare cases Haemophilus influenzae Acinetobacter baumannii and Klebsiella pneumoniae (KP), 2,[4][5][6] a phenomenon that can be attributed to the extensive use of broad-spectrum antimicrobials. 7 Klebsiella pneumoniae (KP) is an Enterobacteriaceae that causes opportunistic infection with community or nosocomial acquirement.…”

“…Without efficient treatment, the patient develops toxic shock, dyspnea and a sharp drop in heart rate, and death. 2 Great clinical acumen necessitates prompt diagnosis followed by emergent aggressive interventions of intravenous antibiotics to constrict infection deterioration or dissemination and adequate drainage to relieve the patient's cardiac compression. 5,25,28,29 Both empirical use of broad-spectrum antibiotics and pathogen-specific antibiotic regimen should be considered.…”

Acute myocardial infarction complicated by purulent pericarditis: A case report

“…S. aureus , Haemophilus influenzae , Neisseria meningitides , and Streptococcus pneumoniae have been reported as causative organisms of purulent pericarditis. [4][5][6][7][8] Although pericardial infection after catheterization for acute myocardial infarction is rare, it should be considered when the inflammatory response is high, and the intraoperative pericardial fluid is white and cloudy instead of bloody, as in this case. In such a case, the shock state may be caused not only by pericardial tamponade but also by sepsis, and an appropriate response is required for the infection.…”