Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child
| Autor: | Abdulazeez Imam, Adamu Sa'idu Adamu, Mustafa O Asani, Raymond Belonwu, Ibrahim Aliyu, Ismail Mohammed Inuwa, Umar Isah Umar, Igoche David Peter |
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| Rok vydání: | 2016 |
| Předmět: |
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty medicine.medical_treatment lcsh:Surgery lcsh:Medicine Pericardial effusion Pericarditis Cardiac tamponade purulent pericarditis medicine medicine.diagnostic_test Respiratory distress business.industry lcsh:R Pulsus paradoxus lcsh:RD1-811 medicine.disease Surgery pericardiocentesis Klebsiella pneumoniae lcsh:RC666-701 Pericardiocentesis pyopericardium Nigerian child Septic arthritis medicine.symptom Chest radiograph business |
| Zdroj: | Journal of the Practice of Cardiovascular Sciences, Vol 2, Iss 3, Pp 194-196 (2016) |
| ISSN: | 2395-5414 |
| Popis: | In the Western world, cases of purulent pericarditis have become almost nonexistent with progress and advent of new immunizations against many causative organisms. We report Klebsiella pneumoniae pericarditis, a rare cause of this uncommon disease, hitherto unreported in Nigeria. K. pneumoniae, which is a rod-shaped, Gram-negative, facultative anaerobe, produces extended-spectrum beta-lactamases; hence, it is usually resistant to a lot of antibiotics and is associated with a significant case fatality rate. Our 13-year-old male patient had septic arthritis of the right hip joint came with a 3 weeks complaint of difficulty with breathing. He had respiratory distress, tachypnea, and tachycardia. Although blood pressure was normal, he had pulsus paradoxus, elevated jugular venous pressure, diffuse apex beat, and heart sounds were distant. Chest radiograph revealed an increased cardiothoracic ratio (0.86) with “water bottle” appearance. Transthoracic echocardiography confirmed pericardial effusion with cardiac tamponade. Echo-guided pericardiocentesis was done, and 340 ml of foul-smelling and creamy pus with greenish tinge was aspirated and this grew K. pneumoniae sensitive to ciprofloxacin and gentamycin but resistant to other conventional antibiotics. Recovery was complete after a week of pericardial tube drainage and 3 weeks of treatment. To the best of our knowledge, this is the first case of Klebsiella - induced pyopericardium and with successful management in a Nigerian child. Pyopericardium may follow rare causes such as K. pneumoniae infection with its unique antibiogram. |
| Databáze: | OpenAIRE |
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