Infectious Disease Compendium

Pericarditis

Diagnosis

Infections of the pericardium and the pericardial space with fevers, chest pain, diffuse ST and PR changes on EKG, signs of cardiac tamponade; echocardiogram will aid in making the diagnosis.

Review

Epidemiologic Risks

Depends of the organism: if infectious it is usually either hematogenous or direct extension. There is an idiopathic recurrant form of the disease.

Microbiology

While any organism can cause pericarditis, here are some common and/or interesting causes:

Viral: enterovirus (Coxsackie B).

Bacterial: S. pneumonia, S. aureus.

Mycobacterial: MTb.

Fungal: Histoplasmosis.

Parasite: E. histolytica (liver abscess ruptures into the pericardium).

Empiric Therapy

Acute pyogenic pericarditis usually requires emergent drainage plus antibiotics. Nafcillin / oxacillin OR vancomycin PLUS third generation cephalosporins.

Chronic disease depends on the clinical suspicion.

Idiopathic relapsing responds to colchicine (PubMed) as does acute percarditis at a dose of 0.5 mg bid for 3 months for patients weighing >70 kg or 0.5 mg qd for patients weighing ≤70 kg (PubMed).

Pearls

Rants