Case Report Open Access

The Difficulties of Diagnosing a Rare Entity in a Common Situation

Manel Maymí Ballesteros1, Toni Soriano Colomé1,2, Antonia Sambola1,2,3 and Jaume Sagristà-Sauleda1
  • 1 Department of Cardiology, University Hospital Vall d’Hebron, Barcelona, Spain
  • 2 Universitat Autònoma de Barcelona, Barcelona, Spain
  • 3 Department of Cardiology and Research Institute, University Hospital Vall d’Hebron, Universitat Autònoma, CIBER Cardiovascular Diseases (CIBER-CV), Barcelona, Spain

Abstract

Acute purulent pericarditis is rare and more prevalent in the pre-antibiotic era with high mortality, around 40% despite optimal treatment. The diagnosis can be difficult, requiring the practice of a pericardiocentesis in cases with a high index of suspicion. When such a rare entity coincides with another one more frequently the diagnosis can become tricky. We present the case of a man with a previous thoracic surgery who was admitted due to an ST Elevation Myocardial Infarction (STEMI) and was finally diagnosed with Methicillin Susceptible Staphylococcus Aureus (MSSA) purulent pericarditis requiring cardiac surgery. The main difficulty, in this case, was the differentiation between hemopericardium and purulent pericardium. Despite the initial difficulties, the systematic study of febrile syndrome and bacteremia allowed reaching the final diagnosis.

American Journal of Infectious Diseases
Volume 19 No. 2, 2023, 23-27

DOI: https://doi.org/10.3844/ajidsp.2023.23.27

Submitted On: 28 August 2022 Published On: 7 April 2023

How to Cite: Ballesteros, M. M., Colomé, T. S., Sambola, A. & Sagristà-Sauleda, J. (2023). The Difficulties of Diagnosing a Rare Entity in a Common Situation. American Journal of Infectious Diseases, 19(2), 23-27. https://doi.org/10.3844/ajidsp.2023.23.27

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Keywords

  • Bacteriemia
  • Purulent Pericarditis
  • Hemopericardium
  • Constrictive Pericarditis