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Autopsy Cardiac Examination
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
In purulent pericarditis, the amount of pericardial fluid is measured and its character noted. If indicated, a pericardial fluid sample is taken by needling through an area of pericardium which has been seared for sterilization. The surface of the visceral as well as parietal pericardium is examined for exudates, adhesions, tumour nodules or dense fibrosis associated with constrictive pericarditis, which can follow infections such as tuberculosis or previous cardiac operations or may be idiopathic. Samples of the thickened pericardium from cases of constrictive pericarditis are often sent for analysis. Usually, the samples show dense fibrosis and nonspecific chronic inflammation. Very rarely, necrotizing granulomas indicating tuberculosis or rheumatoid nodules may be noted.
Morphologic features and pathology of the elderly heart
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Atsuko Seki, Gregory A. Fishbein, Michael C. Fishbein
Acute pericarditis is caused by a wide range of disorders (162,163). The acute inflammatory response in pericarditis produces serous or purulent pericardial effusions or dense fibrinous exudates (164). Viral infection tends to cause serous, low-volume pericardial effusions. Neoplasms and tuberculous pericarditis cause exudative, hemorrhagic effusions. Bacterial infections cause purulent pericarditis. The cause of acute pericarditis is unclear in most patients, but often presumed to be viral (162).
Cardiac surgery
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Infection and inflammation may also affect the pericardium. Acute pericarditis usually occurs following a viral illness. Treatment is with non-steroidal anti-inflammatory drugs and bed rest (in case there is an underlying myocarditis). Acute purulent pericarditis is uncommon but requires urgent drainage and intravenous antibiotics, with attention to the underlying cause.
Acute purulent pericarditis treated conservatively with intrapericardial fibrinolysis and intrapericardial and systemic antibiotics
Published in Baylor University Medical Center Proceedings, 2021
Mahmoud Abdelnabi, Abdallah Almaghraby, Yehia Saleh, Alyaa El Sayed, Judy Rizk
Purulent pericarditis is typically present as an acute illness characterized by high-grade fever, tachycardia, cough, and less commonly chest pain. In the postoperative setting, most patients with purulent pericarditis also have signs of mediastinitis or sternal wound infection. Cardiac tamponade may also occur.3S. aureus is the most common implicated pathogen, while Streptococcus pneumoniae is the most common organism in the setting of direct extension of an intrathoracic infection. Other causes include gram-positive organisms, fungi, and Mycobacterium tuberculosis. Polymicrobial infections are uncommon.4–6 Pericardial fluid analysis including chemical testing (for protein and glucose content as well as white cell count), microscopy (gram stain, acid-fast stain, and fungal stain), and culture and sensitivity is the mainstay for the diagnosis of purulent pericarditis.7
Acupuncture related acute purulent pericarditis masquerading uremic pericarditis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Waqas Ullah, Sohaib Roomi, Zeeshan Sattar, Asrar Ahmad, Zain Ali, Usman Sarwar, Vincent Figueredo
Evaluation for purulent pericarditis should be done in patients with signs of sepsis. The common presenting complaint of IE was high-grade fever, chills and rarely the skin stigmata of IE with or without the joint pains. The factors which seemed to attribute to the development of infective endocarditis were lack of antibiotic prophylaxis, unsterilised procedures, migration of skin flora into the heart tissues and a history of rheumatic heart disease and smoking [2]. A prior history of rheumatic heart disease is a direct contributing factor towards developing IE [10]. Patients who had acupuncture performed on earlobes had a high incidence of IE [4,6–8]. These findings could be hypothesized by the proximity of earlobes to the heart muscles and gravity directed increased venous drainage into the heart with respect to the lower limbs, where the incidence of IE was low.
Purulent Pericarditis in Sickle Cell Disease Due to Streptococcus agalactiae; a Unique Case Report and Literature Review
Published in Hemoglobin, 2019
Alina Bhat, Elvira Neculiseanu, Eric L. Tam, Adam Gendy, Daniel L. Beckles, Carol Luhrs, Albert Braverman
In the modern antibiotic era, purulent pericarditis is usually due to bacteremia or direct intrathoracic spread with Staphylococcus aureus and Streptococcus spp accounting for 36.0% and 26.0% of cases, respectively. Of interest, although Mycobacterium tuberculosis is a rare cause of purulent pericarditis (1.0%) [21], it was reported in two of the four patients with sickle cell disease (Table 1). Due to this small number of reported cases, it is difficult to draw any definitive conclusions.