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Pericarditis as a presenting sign of infective endocarditis: two case reports and review of the literature
- Source :
- Scandinavian journal of infectious diseases. 40(10)
- Publication Year :
- 2008
-
Abstract
- Pericarditis as a presenting sign of infective endocarditis is rare. Here we describe 2 cases and an additional 19 cases of pericarditis as a presenting sign of infective endocarditis reported during the last 40 y. 71% of patients were young males (mean age 43.2 y). The most commonly reported underlying conditions were diabetes mellitus type 2 (5 patients, 24%), and substance or alcohol abuse (4 patients, 19%). The native aortic valve was the most frequently involved valve. The most common symptoms were fever, cough or dyspnoea, and chest pain. Overt tamponade was diagnosed in 47% of the patients. However, pulsus paradoxus and pericardial friction rub were rare. A heart murmur was heard in 12 patients (57%). Staphylococcus aureus was the most commonly isolated pathogen concomitantly from blood and pericardial fluid. 16 patients (76%) were operated. Six underwent a pericardial procedure, 5 underwent valve replacement, 4 both, and 1 patient was operated for pseudoaneurysm. Mortality rates were 60% and 31% of patients treated with antibiotics alone versus antibiotics and surgical intervention, respectively. In patients presenting with pericarditis with or without cardiac tamponade, the possibility of infective endocarditis should be considered. Optimal therapy should consist of antibiotics and surgical intervention.
- Subjects :
- Microbiology (medical)
Adult
Male
medicine.medical_specialty
Staphylococcus aureus
Adolescent
Fever
medicine.medical_treatment
Pericarditis
Valve replacement
Cardiac tamponade
Pericardial friction rub
medicine
Endocarditis
Humans
Aged
Aged, 80 and over
General Immunology and Microbiology
business.industry
Pulsus paradoxus
Pericardial fluid
General Medicine
Endocarditis, Bacterial
Middle Aged
Staphylococcal Infections
medicine.disease
Surgery
Anti-Bacterial Agents
Cardiac Tamponade
Infectious Diseases
Infective endocarditis
Female
Methicillin Resistance
medicine.symptom
business
Cloxacillin
Subjects
Details
- ISSN :
- 00365548
- Volume :
- 40
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Scandinavian journal of infectious diseases
- Accession number :
- edsair.doi.dedup.....4d306eceb752db67b80b3d4e0168c125