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Title: Purulent pneumococcal pericarditis, a vaccine-preventable illness.
Austin Authors: Rees, Matthew J ;Wilson, Andrew
Affiliation: Department of Haematology, Austin Health, Heidelberg, Victoria, Australia
Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
Issue Date: Aug-2019
Date: 2019-08-29
Publication information: Oxford medical case reports 2019; 2019(8): omz078
Abstract: A 74-year-old gentleman presented to hospital with a 1-day history of acute onset pleuritic chest pain and fever. He was found to have widespread ST segment elevation on electrocardiogram, and blood cultures taken were positive for Streptococcus pneumoniae. Two days following admission the patient developed dyspnea, and a large pericardial effusion and right middle lobe consolidation were demonstrated on a computed tomography scan of the chest. A transthoracic echocardiogram confirmed the presence of a large circumferential pericardial effusion with multiple prominent adhesions and marked heterogenous thickening of the pericardium, without evidence of tamponade. Pericardiocentesis drained a purulent exudate positive for pneumococcal antigen. The occurrence of purulent pericarditis secondary to pneumococcal community-acquired pneumonia is rare in the modern antibiotic era and represents an often-lethal manifestation of invasive pneumococcal disease (IPD). IPD is a vaccine-preventable illness for which adult vaccination rates are low despite high morbidity. Healthcare professionals need to vaccinate older patients opportunistically.
DOI: 10.1093/omcr/omz078
Journal: Oxford medical case reports
PubMed URL: 31772745
ISSN: 2053-8855
Type: Journal Article
Appears in Collections:Journal articles

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