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Citrobacter freundii: A Cause of Cardiac Tamponade and Empyema Thoracis in a Nigerian Child
- Source :
- Journal of Cardiovascular Echography
- Publication Year :
- 2020
- Publisher :
- Wolters Kluwer - Medknow, 2020.
-
Abstract
- Citrobacter infection is an uncommon but serious, difficult to treat infection associated with high mortality. Accumulation of pus or fluid in a pericardial space causes restriction of cardiac filling and consequent decrease in cardiac output. We herein report Citrobacter freundii, a rare infectious cause of this uncommon disorder. Our patient is a 10yr old male referred with complaints of cough productive of mucoid sputum and associated chest pain of two weeks duration, difficulty in breathing and orthopnoea for one week. He was acutely ill looking in respiratory distress with tachypnoea and tachycardia. Blood pressure was normal with pulsus alternans, there was increased jugular venous pressure, diffused apex beat and distant heart sounds with pericardial rub. Retroviral screening and gene Xpert for Mycobacterium tuberculosis were negative. Chest radiograph showed enlarged heart of “water bottle” appearance with cardiothoracic ratio of 0.77 and right sided pleural effusion which was drained. Transthoracic Echocardiogram confirm pyopericardium with multiples echoes in cardiac temponade. Echo-guided percutaneous pericardiocentesis yielded 600mls of purulent aspirates. Citrobacter freundii Sensitive to gentamycin, co-amoxiclav but resistant to cefuroxime and cefixime was cultured from pericardial aspirates and sputum. Patient recovered fully after pericardiocentesis and intravenous antibiotics. In this case report, we describe Citrobacter freundii causing cardiac temponade and empyema in a Nigerian immunocompetent child which to our knowledge has thus far not been reported. Pyopericardium may follow rare causes as Citrobacter freundii which require high index of suspicion.
- Subjects :
- medicine.medical_specialty
Pleural effusion
medicine.medical_treatment
Case Report
Empyema thoracis
Chest pain
Cardiac tamponade
medicine
Radiology, Nuclear Medicine and imaging
Pyopericardium
biology
medicine.diagnostic_test
business.industry
Nigerian
biology.organism_classification
medicine.disease
Empyema
Citrobacter freundii
Surgery
Pericardiocentesis
Transthoracic echocardiogram
medicine.symptom
Cardiology and Cardiovascular Medicine
Chest radiograph
business
Subjects
Details
- Language :
- English
- ISSN :
- 2347193X and 22114122
- Volume :
- 30
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Echography
- Accession number :
- edsair.doi.dedup.....091688623b9ff6925e8c04d7eeb02c13