Successful Management of an Occult Cardiac Tamponade with Prompt Surgical Intervention and a Novel, Defined Pericardial Irrigation Protocol

Abstract

Purulent pericarditis is a rare entity in the postantibiotic era. It usually occurs in patients who have underlying chronic and immunosuppressing conditions and its presentation in the healthy adult population is quite rare. Infection of the pericardial space can occur via direct extension from infectious endocarditis, pneumonia, or empyema, or from a more distant source such as meningitis. Purulent pericarditis carries a very high mortality because of delay in the diagnosis and early occurrence of fatal complications. We describe a case of purulent pericarditis with impending cardiac tamponade in a previously healthy 40-year-old female patient, which was successfully treated with a combination of prompt surgical drainage and a novel irrigation protocol.

Keywords

cardiovascular surgery - empyema - infection - pericardium

• References

• 1 Park S, Bayer AS. Purulent pericarditis. Curr Clin Top Infect Dis 1992; 12: 56-82
• 2 Juneja R, Kothari SS, Saxena A, Sharma R, Joshi A. Intrapericardial streptokinase in purulent pericarditis. Arch Dis Child 1999; 80 (3) 275-277
• 3 Majid AA, Omar A. Diagnosis and management of purulent pericarditis. Experience with pericardiectomy. J Thorac Cardiovasc Surg 1991; 102 (3) 413-417