RESUMEN
OBJECTIVE: Epicardial fat thickness (EFT) and chlamydia infection are independent cardiovascular risk factors in coronary artery disease (CAD). We aimed to evaluate the effect of coexistence of EFT and chlamydia infection on the presence and severity of CAD in patients with stable angina pectoris (SAP). PATIENTS AND METHODS: The study included 208 patients with SAP, divided into a CAD group (n=112) and a control group (n=96). The presence of Chlamydia pneumoniae-IgG (CP-IgG), EFT, and left ventricular ejection fraction (LVEF) were compared between groups. RESULTS: CP-IgG, LVEF, and EFT were found to be independent predictors of CAD (CP-IgG, OR=1.559, p=0.021; LVEF, OR=0.798, p<0.001; EFT, OR=3.175, p=0.026). Moreover, a statistically significant interaction was detected between CP-IgG and EFT for predicting the presence of CAD (p<0.001). A good positive correlation was found between EFT and Gensini score (r=0.684, p<0.001). CONCLUSIONS: We found that there was an interaction between CP-Ig and EFT for CAD development. This finding suggests that the interaction of CP-IgG and EFT plays a prominent role in the inflammatory process.
Asunto(s)
Angina Estable/diagnóstico por imagen , Infecciones por Chlamydia/diagnóstico por imagen , Chlamydophila pneumoniae/aislamiento & purificación , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Pericardio/diagnóstico por imagen , Angina Estable/microbiología , Infecciones por Chlamydia/microbiología , Enfermedad de la Arteria Coronaria/microbiología , Ecocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pericardio/microbiologíaRESUMEN
The bacterial purulent pericarditis is rapidly progressive and represents a highly fatal infection, with mortality rates reaching up to 100% if untreated. Approximately 40% to 50% of all cases are caused by Gram-positive bacteria, especially Streptococcus pneumoniae. We describe an extremely rare case of S. pneumoniae purulent pericarditis as a delayed complication of a blunt thoracic trauma. The patient was successfully treated with urgent pericardiocentesis, thoracoscopic pericardial fenestration, and broad-spectrum antibiotics. Owing to the high mortality rate of a purulent pericarditis, a high index of suspicion is needed in order to instaurate an appropriate therapy with drainage and antibiotics.
Asunto(s)
Pericarditis/etiología , Pericardio/diagnóstico por imagen , Infecciones Neumocócicas/etiología , Traumatismos Torácicos/complicaciones , Heridas no Penetrantes/complicaciones , Anciano de 80 o más Años , Ecocardiografía , Femenino , Humanos , Pericarditis/diagnóstico , Pericarditis/microbiología , Pericardio/microbiología , Infecciones Neumocócicas/diagnóstico , Infecciones Neumocócicas/microbiología , Radiografía Torácica , Enfermedades Raras , Streptococcus pneumoniae/aislamiento & purificación , Traumatismos Torácicos/diagnóstico , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/diagnósticoAsunto(s)
Antituberculosos/uso terapéutico , Pericarditis Tuberculosa/diagnóstico , Pericardio/patología , Biopsia , Errores Diagnósticos , Corazón/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Pericardiectomía , Pericarditis Tuberculosa/diagnóstico por imagen , Pericarditis Tuberculosa/tratamiento farmacológico , Pericardio/microbiología , Pericardio/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Post-operative Aspergillus mediastinitis is regarded to be a devastating infection, usually affecting patients undergoing cardiothoracic surgery with specific predisposing factors characterised by a high mortality and chronic morbidity. Patient outcome after such a complication is extremely poor despite antifungal therapy and surgery. We describe the case of an immunocompetent 2-month-old child with obstructed supracardiac total anomalous pulmonary venous circulation (TAPVC) and severe pulmonary artery hypertension, who underwent TAPVC repair through median sternotomy and developed post-operative mediastinitis due to Aspergillus flavus.
Asunto(s)
Aspergilosis/complicaciones , Aspergillus flavus/aislamiento & purificación , Mediastinitis/microbiología , Complicaciones Posoperatorias/microbiología , Aspergilosis/terapia , Resultado Fatal , Humanos , Inmunocompetencia , Lactante , Masculino , Pericardio/microbiología , Complicaciones Posoperatorias/terapia , Hipertensión Arterial Pulmonar/cirugía , Venas Pulmonares/anomalíasAsunto(s)
Pericarditis Tuberculosa/diagnóstico , Antituberculosos/uso terapéutico , Biopsia , Progresión de la Enfermedad , Quimioterapia Combinada , Humanos , Ganglios Linfáticos/microbiología , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Pericardiocentesis , Pericarditis Tuberculosa/diagnóstico por imagen , Pericarditis Tuberculosa/tratamiento farmacológico , Pericarditis Tuberculosa/patología , Pericardio/microbiología , Pericardio/patología , Prednisona/uso terapéutico , Evaluación de Síntomas , Tomografía Computarizada por Rayos X , Tuberculoma/microbiología , Tuberculoma/patologíaAsunto(s)
Calcinosis/patología , Endocarditis Bacteriana/patología , Enfermedades de las Válvulas Cardíacas/patología , Válvula Mitral/patología , Pericardio/patología , Anciano de 80 o más Años , Calcinosis/microbiología , Calcinosis/terapia , Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana/terapia , Resultado Fatal , Enfermedades de las Válvulas Cardíacas/microbiología , Enfermedades de las Válvulas Cardíacas/terapia , Humanos , Masculino , Válvula Mitral/microbiología , Pericardio/microbiología , Rotura Espontánea/microbiología , Rotura Espontánea/patología , Rotura Espontánea/terapiaRESUMEN
Meningococcal pericarditis is a rare but severe form of acute purulent pericarditis. It is a classic complication of Neisseria meningitidis of serotype W135, usually occurring in pilgrims to Mecca and their household contacts. This severe form of meningococcaemia is difficult to diagnose and evolves frequently and gradually towards a tamponade, requiring emergency drainage. We report a case of meningococcal pericarditis caused by N. meningitidis W135 in an immunocompetent patient, without any other organ involvement especially meningeal, requiring pericardium drainage in emergency and then intrapericardial fibrinolysis.
Asunto(s)
Fibrinólisis/fisiología , Neisseria meningitidis/aislamiento & purificación , Pericarditis Constrictiva/diagnóstico por imagen , Pericardio/microbiología , Drenaje/métodos , Ecocardiografía Transesofágica/métodos , Humanos , Masculino , Infecciones Meningocócicas/microbiología , Persona de Mediana Edad , Pericarditis Constrictiva/tratamiento farmacológico , Pericarditis Constrictiva/microbiología , Pericarditis Constrictiva/cirugía , Pericardio/efectos de los fármacos , Pericardio/cirugía , Resultado del Tratamiento , Activador de Plasminógeno de Tipo Uroquinasa/administración & dosificación , Activador de Plasminógeno de Tipo Uroquinasa/uso terapéuticoRESUMEN
We report an extremely rare case of purulent pericarditis caused by the normally commensal oral flora, Streptococcus constellatus, a viridans Streptococcal species and member of the S. anginosus group (previously also known by the eponymous 'S. milleri', for American Willoughby Dayton Miller). This case is a previously healthy 71-year-old immunocompetent woman from Arizona who presented with a 5-day history of progressive shortness of breath and chest tightness, and subjective fever and chills, but without history of nausea, vomiting, night sweats, recent travel, autoimmune disease or sick contacts. Early recognition and intervention of purulent pericarditis allow patients like the one outlined in this case to achieve full recovery.
Asunto(s)
Pericarditis/diagnóstico por imagen , Pericarditis/microbiología , Infecciones Estreptocócicas/complicaciones , Streptococcus constellatus/aislamiento & purificación , Anciano , Antibacterianos/uso terapéutico , Ceftriaxona/uso terapéutico , Diagnóstico Diferencial , Ecocardiografía , Femenino , Humanos , Derrame Pericárdico/diagnóstico por imagen , Derrame Pericárdico/tratamiento farmacológico , Derrame Pericárdico/microbiología , Pericarditis/tratamiento farmacológico , Pericardio/diagnóstico por imagen , Pericardio/microbiología , Infecciones Estreptocócicas/diagnóstico por imagen , Infecciones Estreptocócicas/tratamiento farmacológico , Tomografía Computarizada por Rayos XRESUMEN
Fowl adenovirus serotype 4 (FAdV-4), a member of the Aviadenovirus genus of the Adenoviridae family, causes hepatitis-hydropericardium syndrome (HHS) in chickens. It causes mortality of up to 80% in 3-6-week-old broilers, posing a substantial threat to the poultry industry. However, the specific host responses to the virus are not well understood. To better understand the interactions between the host and FAdV-4 and to explore the pathogenesis of this virus, a high-throughput RNA-seq technology was utilized with leghorn male hepatocellular (LMH) cells at 12, 24, and 48â¯h after FAdV-4 infection. We identified a total of 7000 differentially expressed genes (DEGs), which were enriched in a variety of biological processes and pathways using the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Several immune related pathways, including Toll-like receptor (TLR) signaling pathway and cytokine-cytokine receptor interaction pathway, were activated after the FAdV-4 infection. The transcriptional data were validated by quantitative real-time PCR. The expression profiles of 10 genes involved in FAdV-4-infected chicken livers, including TLR2A, TLR3, TLR5, MyD88, IL12B, IL15, IL18, CCL20, TNFRSF21, and CD30, were consistent with RNA-seq profiles. By transfecting small interfering RNA into LMH cells, our results confirmed that MyD88 mediated FAdV-4-induced inflammation. To our knowledge, this was the first study to use transcriptome analysis to investigate host responses to FAdV-4 infection. These findings provide insights into the mechanisms of FAdV-4 pathogenesis and host-FAdV-4 interaction.
Asunto(s)
Infecciones por Adenoviridae/veterinaria , Aviadenovirus/genética , Perfilación de la Expresión Génica , Hígado/citología , Enfermedades de las Aves de Corral/microbiología , Infecciones por Adenoviridae/inmunología , Infecciones por Adenoviridae/microbiología , Animales , Aviadenovirus/inmunología , Aviadenovirus/patogenicidad , Recuento de Células , Pollos/virología , Hepatitis Animal/microbiología , Interacciones Huésped-Patógeno/genética , Interacciones Huésped-Patógeno/inmunología , Hígado/inmunología , Hígado/microbiología , Hígado/patología , Masculino , Pericardio/microbiología , Pericardio/patología , Filogenia , Enfermedades de las Aves de Corral/inmunología , Análisis de Secuencia de ADN , Serogrupo , Receptores Toll-Like/genéticaRESUMEN
BACKGROUND: The etiology of infective endocarditis (IE) is changing. More aggressive forms with multiple IE cardiac lesions have become more frequent. This study sought to explore the relationship between contemporary causative microorganisms and IE cardiac lesions and to analyze the impact of multiple lesions on treatment choice. METHODS: In 246 patients hospitalized for IE between 2008 and 2015, cardiac lesions caused by IE were analyzed by echocardiography, classified according to the 2015 European Society of Cardiology guidelines and correlated with microbiological data. We defined a new parameter, the Echo IE Sum, to summarize all IE cardiac lesions in a single patient, enabling comprehensive comparisons between different etiologies and treatment strategies. RESULTS: Staphylococcus aureus was associated with the development of large vegetation (OR 2.442; 95% CI 1.220-4.889; p=0.012), non-HACEK bacteria with large vegetation (OR 13.662; 95% CI 2.801-66.639; p=0.001), perivalvular abscess or perivalvular pseudoaneurysm (OR 5.283; 95% CI 1.069-26.096; p=0.041), and coagulase-negative staphylococci (CoNS) with leaflet abscess or aneurysm (OR 3.451; 95% CI 1.285-9.266, p=0.014), and perivalvular abscess or perivalvular pseudoaneurysm (OR 4.290; 95% CI 1.583-11.627; p=0.004). The Echo IE Sum significantly differed between different etiologies (p<0.001), with the highest value in non-HACEK and the lowest in streptococcal endocarditis. Patients operated for IE had a significantly higher Echo IE Sum vs those who were medically treated (p<0.001). CONCLUSION: None of the IE cardiac lesions is microorganism-specific. However, more severe lesions were caused by S. aureus, CoNS, and non-HACEK bacteria. The highest propensity to develop multiple lesions was shown by the non-HACEK group. Higher Echo IE Sum in patients sent to surgery emphasized the importance of multiple IE cardiac lesions on treatment choice and potential usage of Echo IE Sum in patient management.
Asunto(s)
Absceso/microbiología , Aneurisma Falso/microbiología , Endocarditis/microbiología , Aneurisma Cardíaco/microbiología , Pericardio/microbiología , Adulto , Anciano , Estudios de Cohortes , Ecocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones Estafilocócicas/microbiología , Staphylococcus aureusRESUMEN
Pericardial effusion is the abnormal accumulation of fluid in the pericardial space. The complications of pericardial effusion can either be acute (e.g., cardiac tamponade) or chronic (e.g., constrictive pericarditis). We have conducted a systematic review of the scientific literature to evaluate the efficacy and safety of intrapericardial fibrinolysis in preventing complications of pericardial effusion. We searched for both published and unpublished studies. 29 studies, with a total of 109 patients were included in this review; 17 case reports, 11 case series, and one randomised controlled trial (RCT). All included studies had a high risk of bias. The most common causes of pericardial effusion were Staphylococcus aureus (12 studies with 23 cases) and Mycobacterium tuberculosis (2 studies with 19 cases). The most common fibrinolytic agents used were streptokinase (15 studies) and urokinase (5 studies). Intrapericardial fibrinolysis prevented complications in 94 (86.2%) patients. Non-fatal procedure-related complications were reported 21 (19.2%) patients. No patient died following intrapericardial fibrinolysis. There is very low certainty of the efficiency and safety of intrapericardial fibrinolysis in preventing the complications of pericardial effusion. High quality RCTs are required to address this question.
Asunto(s)
Fibrinólisis/efectos de los fármacos , Fibrinolíticos/administración & dosificación , Derrame Pericárdico/tratamiento farmacológico , Pericardio/efectos de los fármacos , Fibrinólisis/fisiología , Fibrinolíticos/farmacología , Humanos , Derrame Pericárdico/diagnóstico , Pericarditis/diagnóstico , Pericarditis/tratamiento farmacológico , Pericardio/microbiología , Pericardio/patología , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Estreptoquinasa/farmacología , Estreptoquinasa/uso terapéutico , Resultado del TratamientoAsunto(s)
Actinomyces/aislamiento & purificación , Actinomicosis , Antibacterianos/administración & dosificación , Ecocardiografía/métodos , Trastornos de la Motilidad Esofágica/diagnóstico , Eubacterium/aislamiento & purificación , Fusobacterium nucleatum/aislamiento & purificación , Enfermedades Pulmonares , Derrame Pericárdico , Esclerodermia Sistémica/complicaciones , Actinomicosis/diagnóstico , Actinomicosis/fisiopatología , Taponamiento Cardíaco/diagnóstico , Taponamiento Cardíaco/etiología , Taponamiento Cardíaco/fisiopatología , Taponamiento Cardíaco/cirugía , Trastornos de la Motilidad Esofágica/etiología , Humanos , Biopsia Guiada por Imagen/métodos , Pulmón/microbiología , Pulmón/patología , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/microbiología , Imagen por Resonancia Cinemagnética/métodos , Masculino , Persona de Mediana Edad , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/etiología , Derrame Pericárdico/fisiopatología , Derrame Pericárdico/terapia , Pericardiectomía/métodos , Pericardio/microbiología , Pericardio/patología , Esclerodermia Sistémica/diagnóstico , Resultado del TratamientoRESUMEN
Campylobacter fetus is an organism residing primarily in the gastrointestinal tracts of cattle and sheep and transmitting to humans through ingestion of contaminated food products or surface water. The organism has caused various extraintestinal infections but, to date, purulent pericarditis due to the organism has rarely been described. We report a case of purulent pericarditis due to C. fetus subsp. fetus, occurring in a patient having several predisposing conditions, including receiving hemodialysis therapy, recent surgery for cecal cancer, and administration of esomeprazole. The patient mentioned having eaten homemade raw beef liver two weeks before the onset, suggesting that the ingested food product was contaminated with C. fetus and the organism transmitted to the pericardium through the bloodstream although blood culture was negative. The causative organism, recovered from the pericardial effusion, was unidentifiable with commercial systems but determinable with molecular methods at the subspecies level. The patient fully improved with pericardiocentesis and subsequent administration of ciprofloxacin, to which the organism was considered susceptible, for a total of four weeks. This is the first case of C. fetus pericarditis in which a history of ingesting a raw food product was clearly mentioned.
Asunto(s)
Infecciones por Campylobacter/microbiología , Campylobacter fetus/aislamiento & purificación , Pericarditis/microbiología , Alimentos Crudos/microbiología , Animales , Antibacterianos/administración & dosificación , Secuencia de Bases/genética , Infecciones por Campylobacter/tratamiento farmacológico , Campylobacter fetus/genética , Bovinos , Ciprofloxacina/administración & dosificación , Tracto Gastrointestinal/microbiología , Humanos , Hígado/microbiología , Masculino , Persona de Mediana Edad , Pericarditis/tratamiento farmacológico , Pericardio/microbiología , OvinosRESUMEN
Primary intestinal lymphangiectasia (Waldmann's disease) is an exudative enteropathy characterized by lymph leakage into the small bowel lumen leading to hypoalbuminemia, hypogammaglobulinemia and lymphopenia (particularly T-cell). The diagnosis is based on viewing the duodenal lymphangiectasia. A 20 years old female patient, treated for a primary intestinal lymphangiectasia, has consulted for anasarca. Etiological work-up reveals pleural and pericardial tuberculosis. The clinical aggravation of an enteropathy, particularly in adulthood, requires a search for a secondary etiology. Tuberculosis should be sought systematically.
Asunto(s)
Linfangiectasia Intestinal/diagnóstico , Linfedema/diagnóstico , Pericardio/microbiología , Tuberculosis Pleural/diagnóstico , Tuberculosis/diagnóstico , Femenino , Humanos , Linfangiectasia Intestinal/etiología , Linfedema/etiología , Tuberculosis/complicaciones , Tuberculosis/fisiopatología , Tuberculosis Pleural/complicaciones , Adulto JovenRESUMEN
Invasive aspergillosis(IA) is a potentially lethal complication of Aspergillus infection affecting mainly immunocompromised hosts; however, during the last two decades its incidence was increasingly observed in critically ill immunocompetent patients. The objective of this study is to describe the clinical characteristics of histologically proven endomyocardial and pericardial invasion, in the context of IA, in critically ill patients. Eight critically ill patients with histopathological confirmation of endomyocardial/pericardial aspergillosis were evaluated. Risk factors, clinical and laboratory characteristics, treatment, histopathological characteristics and mortality were recorded. Signs and symptoms of cardiac dysfunction were not observed in any of the patients. Therapy was administered to six of them shortly after the first positive culture. The observed histopathological lesions included haemorrhagic lesions, small vessels with central thrombosis and surrounding consolidated tissue with necrosis. Voriconazole, caspofungin, lipid amphotericin B and itraconazole were the used antifungals. The mortality rate was high (87.5%). Endomyocardial and pericardial aspergillosis are devastating complications of invasive aspergillosis. Clinical suspicion is low making the diagnosis difficult, therefore histopathological examination of tissues are required. The mortality is high.
Asunto(s)
Enfermedad Crítica , Cardiopatías/microbiología , Infecciones Fúngicas Invasoras/epidemiología , Infecciones Fúngicas Invasoras/microbiología , Pericardio/microbiología , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Caspofungina , Equinocandinas/uso terapéutico , Femenino , Cardiopatías/tratamiento farmacológico , Cardiopatías/epidemiología , Humanos , Inmunocompetencia , Huésped Inmunocomprometido , Incidencia , Infecciones Fúngicas Invasoras/tratamiento farmacológico , Lipopéptidos/uso terapéutico , Masculino , Persona de Mediana Edad , Miocardio/patología , Factores de Riesgo , Voriconazol/uso terapéuticoRESUMEN
BACKGROUND: Epicardial adipose tissue (EAT) has a close functional and anatomic relationship with epicardial coronary arteries. Accumulating evidence suggests that host microbiome alterations may play a role in several inflammatory/immune disorders, triggering a robust proinflammatory response also involving interleukin-1ß (IL-1ß) and the NALP3 inflammasome. In the current study, we explore the hypothesis that in patients with non-ST elevation acute coronary syndrome (ACS), EAT contains potentially pro-atherosclerotic bacteria that might elicit inflammasome activation. METHODS: EAT samples were obtained during coronary artery bypass grafting from ACS (n=18) and effort stable angina (SA; n=16) patients, and as controls, from patients with angiographically normal coronary arteries undergoing surgery for mitral insufficiency (MVD; n=13). In all patients, NALP3 and proIL-1ß mRNA expressions were evaluated with qRT-PCR. In 3 patients from each group, EAT microbiota composition was determined using next-generation sequencing technologies. RESULTS: In EAT, mRNA expression of both NALP3 and pro-IL1ß was significantly higher in ACS than in SA and MVD (P=0.028 and P=0.005, respectively). A broad range of bacterial species (n=76) was identified in both ACS and SA, with different predominant species. In contrast, microbial DNA was barely observed in MVD. CONCLUSIONS: Our study demonstrated the presence of bacterial DNA directly into EAT, surrounding diseased coronary arteries, of patients with ACS. Furthermore, ACS is associated with NALP3/inflammasome pathway activation in EAT. Our data suggest that the EAT environment is susceptible to microbial colonization that might stimulate a proinflammatory response. These findings add new elements to the pathogenesis of ACS and suggest novel therapeutic targets.
Asunto(s)
Síndrome Coronario Agudo , Tejido Adiposo , Puente de Arteria Coronaria/métodos , Inflamasomas/fisiología , Microbiota/fisiología , Pericardio , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/inmunología , Síndrome Coronario Agudo/cirugía , Tejido Adiposo/inmunología , Tejido Adiposo/microbiología , Tejido Adiposo/patología , Anciano , Recuento de Colonia Microbiana/métodos , Vasos Coronarios/patología , ADN Bacteriano/aislamiento & purificación , Femenino , Humanos , Interleucina-1beta/análisis , Italia , Masculino , Persona de Mediana Edad , Proteína con Dominio Pirina 3 de la Familia NLR/análisis , Pericardio/inmunología , Pericardio/microbiología , Pericardio/patología , Estadística como AsuntoAsunto(s)
Absceso , Ecocardiografía , Huésped Inmunocomprometido , Nocardiosis , Nocardia , Pericarditis , Pericardio , Tomografía Computarizada por Rayos X , Absceso/diagnóstico por imagen , Absceso/microbiología , Absceso/patología , Anciano de 80 o más Años , Femenino , Humanos , Nocardiosis/diagnóstico por imagen , Nocardiosis/patología , Pericarditis/diagnóstico por imagen , Pericarditis/microbiología , Pericarditis/patología , Pericardio/diagnóstico por imagen , Pericardio/microbiología , Pericardio/patologíaRESUMEN
We report a case of a 55-year-old woman with a history of type 2 diabetes mellitus, Charcot arthropathy and end-stage renal disease, who presented with a syncopal episode after undergoing haemodialysis. She had a history of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia from an unknown source 3â months earlier, which was treated with an 8-week course of intravenous antibiotics. At the time of presentation to the emergency room, she was found to be in refractory shock. Bedside echocardiogram was performed, which showed moderate pericardial effusion. The effusion was later found to be due to MRSA, which was identified in blood and in pericardial fluid cultures. The patient was successfully treated with intravenous daptomycin for 6â weeks. Acute osteomyelitis of her right foot was the source of the MRSA, for which a right below-knee amputation was ultimately performed.
Asunto(s)
Amputación Quirúrgica , Extremidad Inferior/cirugía , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Osteomielitis/complicaciones , Pericarditis/complicaciones , Pericardio/microbiología , Infecciones Estafilocócicas/complicaciones , Síncope/etiología , Antibacterianos/administración & dosificación , Comorbilidad , Femenino , Humanos , Extremidad Inferior/patología , Persona de Mediana Edad , Osteomielitis/microbiología , Pericarditis/microbiología , Infecciones Estafilocócicas/microbiología , Síncope/microbiología , Resultado del TratamientoAsunto(s)
Mycobacterium tuberculosis/aislamiento & purificación , Pericarditis Tuberculosa/diagnóstico , Pericardio/microbiología , Pericardio/patología , Adolescente , Antituberculosos/uso terapéutico , Biopsia , Quimioterapia Combinada , Ecocardiografía , Humanos , Masculino , Pericarditis Tuberculosa/tratamiento farmacológico , Pericardio/diagnóstico por imagen , Resultado del TratamientoRESUMEN
Pericardial tuberculosis is a specific pericarditis which is rarely reported in the absence of pulmonary tuberculosis. A case history is presented of a 74-year-old patient, immunocompromised as a result of kidney and liver cancer therapy. Mycobacterium tuberculosis was repeatedly recovered from pericardial effusion but not from other clinical specimens. Despite the early treatment of specific pericarditis, the patient died.