Septic pericarditis and pneumopericardium in a dog with an oesophageal foreign body

Abstract

A 5-year-old, intact, male Yorkshire Terrier presented with a 6-day history of lethargy and anorexia. Clinical examination revealed dental plaque accumulation, abdominal effort during respiration and muffled heart sounds. Thoracic radiographs revealed an enlarged globoid cardiac silhouette and mild pneumopericardium, transthoracic ultrasonography revealed a pericardial effusion after which pericardiocentesis, cytology and culture diagnosed septic pericarditis. Three multidrug-resistant bacteria were isolated, two of which have been implicated in gas-producing infections before. Medical management failed to resolve the pericarditis and euthanasia was opted for. A chronic osseocartilaginous oesophageal foreign body cranial to the heart base was found on necropsy. Septic pericarditis and pneumopericardium are rare conditions in dogs. This is the first case to describe a multidrug-resistant polybacterial aetiology causing mild pneumopericardium and only the second case to describe septic pericarditis associated with an oesophageal foreign body.

Case Report: Septic Pericarditis With Achromobacter xyloxidans in an Immunosuppressed Dog

“…Septic pericarditis is typically associated with dog fight wounds, migrating foreign bodies, an extension of local disease, or hematogenous spread of infection ( 4 – 10 ). Infectious organisms that have been implicated in septic pericarditis in dogs include Staphylococcus, Streptococcus, Pseudomonas , Nocardia, Bacteriodes, Pasturella multocida, Actinomyces, Acinetobacter , aspergillosis, Candida albicans , coccidomycosis, and dirofilariasis ( 1 , 4 , 5 , 7 – 10 ). The general treatment recommendations for septic pericarditis include the administration of appropriate antibiotics or antifungals, removing the pericardial fluid via pericardiocentesis, and subtotal pericardectomy ( 2 ).…”

Gastroesophageal intussusception secondary to induction of emesis with subsequent development of septic pericardial effusion after corrective surgery

“…Based on the literature search, this is the first reported case of a septic pericardial effusion subsequent to GEI. More commonly this condition is the consequence of oesophageal foreign bodies (Botha et al 2017, Sheehan et al 2019, penetrating wounds (Veloso et al 2014), systemic infection (Peterson et al 2003) or extension of a local infection (Peterson et al 2003, Casamián-Sorrosal et al 2008, Veloso et al 2014. Unspecified anaerobes (Veloso et al 2014), Pasteurella canis (Sheehan et al 2019) and Staphylococcus sp.…”

“…GEI is a rare and life-threatening condition in the dog, reported to predominantly affect young male dogs, especially the German shepherd, hypothetically due to their predisposition to megaesophagus (Graham et al 1998, Torad & Hassan, 2015. Previously reported complications arising from GEI include aspiration pneumonia (McGill et al 2009), development of oesophageal stricture (Botha et al 2017) and endotoxic shock (Fossum 2007).…”

Systematic review of the treatment options for pericardial effusions in dogs

“…[4][5][6] While neoplasia is the most frequent cause of pericardial effusion, the reported incidence of cardiac tumors is only 0.19%. 6 Approximately 20% of pericardial effusions are idiopathic in origin 3,5 but may also occur due to another disease process such as a ruptured atrium, [7][8][9][10] toxicosis, [11][12][13] penetrating foreign body, [14][15][16][17][18] or infection. [19][20][21][22][23][24] Initial stabilization via pericardiocentesis and fluid resuscitation is often required to relieve compression of the right atrium and ventricle, which normalizes cardiac output and peripheral tissue perfusion.…”

“…While neoplasia is the most frequent cause of pericardial effusion, the reported incidence of cardiac tumors is only 0.19% 6 . Approximately 20% of pericardial effusions are idiopathic in origin 3,5 but may also occur due to another disease process such as a ruptured atrium, 7‐10 toxicosis, 11‐13 penetrating foreign body, 14‐18 or infection 19‐24 …”