Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child
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, whic...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Journal of the Practice of Cardiovascular Sciences |
| Subjects: | |
| Online Access: | http://www.j-pcs.org/article.asp?issn=2395-5414;year=2016;volume=2;issue=3;spage=194;epage=196;aulast=Peter |
| _version_ | 1819131189307375616 |
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| author | Igoche David Peter Raymond Belonwu Mustafa O Asani Ibrahim Aliyu Umar Isah Umar Abdulazeez Imam Adamu S Adamu Ismail M Inuwa |
| author_facet | Igoche David Peter Raymond Belonwu Mustafa O Asani Ibrahim Aliyu Umar Isah Umar Abdulazeez Imam Adamu S Adamu Ismail M Inuwa |
| author_sort | Igoche David Peter |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T09:11:33Z |
| format | Article |
| id | doaj.art-067248029140415288747080837d6972 |
| institution | Directory Open Access Journal |
| issn | 2395-5414 2454-2830 |
| language | English |
| last_indexed | 2024-12-22T09:11:33Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of the Practice of Cardiovascular Sciences |
| spelling | doaj.art-067248029140415288747080837d69722022-12-21T18:31:24ZengWolters Kluwer Medknow PublicationsJournal of the Practice of Cardiovascular Sciences2395-54142454-28302016-01-012319419610.4103/2395-5414.201376Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian ChildIgoche David PeterRaymond BelonwuMustafa O AsaniIbrahim AliyuUmar Isah UmarAbdulazeez ImamAdamu S AdamuIsmail M InuwaIn 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.http://www.j-pcs.org/article.asp?issn=2395-5414;year=2016;volume=2;issue=3;spage=194;epage=196;aulast=PeterCardiac tamponadeNigerian childpericardiocentesis Klebsiella pneumoniaepurulent pericarditispyopericardium |
| spellingShingle | Igoche David Peter Raymond Belonwu Mustafa O Asani Ibrahim Aliyu Umar Isah Umar Abdulazeez Imam Adamu S Adamu Ismail M Inuwa Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child Journal of the Practice of Cardiovascular Sciences Cardiac tamponade Nigerian child pericardiocentesis Klebsiella pneumoniae purulent pericarditis pyopericardium |
| title | Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child |
| title_full | Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child |
| title_fullStr | Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child |
| title_full_unstemmed | Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child |
| title_short | Purulent pericarditis caused by Klebsiella pneumoniae in a Nigerian Child |
| title_sort | purulent pericarditis caused by klebsiella pneumoniae in a nigerian child |
| topic | Cardiac tamponade Nigerian child pericardiocentesis Klebsiella pneumoniae purulent pericarditis pyopericardium |
| url | http://www.j-pcs.org/article.asp?issn=2395-5414;year=2016;volume=2;issue=3;spage=194;epage=196;aulast=Peter |
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