Purulent constrictive pericarditis caused by Salmonella enteritidis in a patient with adult-onset Still's disease A case report

doi:10.1097/MD.0000000000008949

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Title:	Purulent constrictive pericarditis caused by Salmonella enteritidis in a patient with adult-onset Still's disease A case report
Authors:	Kuo, Chia-Cheng Yu, Wen-Liang Lee, Chen-Hui Wu, Nan-Chun
Contributors:	Chi Mei Med Ctr, Div Cardiovasc Surg, Dept Surg Chi Mei Med Ctr, Dept Intens Care Unit Taipei Med Univ, Coll Med, Sch Med, Dept Med Taipei Vet Gen Hosp, Dept Med Educ Natl Def Med Ctr, Sch Med Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm, Biotechnol
Keywords:	adult-onset Still's disease constrictive pericarditis purulent pericarditis Salmonella enteritidis
Date:	2017-12
Issue Date:	2018-11-30 15:54:14 (UTC+8)
Publisher:	Lippincott Williams & Wilkins
Abstract:	Rationale: Purulent pericarditis is a rare and usually fatal disease. Immunodeficiency state and preexisting pericardial effusion can predispose patients to infections. However, we are not aware of similar cases in patients with adult-onset Still's disease (AOSD). In addition, it is seldom caused by Salmonella bacteria. Patient Concerns: We report a 30-year-old woman with dyspnea on exertion and epigastric fullness. She was newly diagnosed with AOSD 4 months previously and medicated with prednisolone. Diagnoses: Transthoracic echocardiography (TTE) and computed tomography revealed a thickened pericardium with loculations in the pericardial space, consistent with purulent constrictive pericarditis. Subsequent cultures of blood and pericardial fluid yielded S enteritidis. Interventions: She underwent subtotal pericardiectomy through a limited median sternotomy, and antibiotic therapy (ceftriaxone) for 1 month. Outcomes: The New York Heart Association functional classification downgraded from class III to class I. There was no recurrence during the 1-year follow-up. Lessons: This case presents an opportunity to highlight the importance of considering purulent pericarditis in patients previously diagnosed with AOSD. High clinical suspicion, early diagnosis, and prompt management can result in a better outcome in purulent pericarditis.
Relation:	Medicine, v.96, n.50, UNSP e8949
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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