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Reminder of important clinical lesson
Case report
Streptococcus anginosus purulent pericarditis with cardiac tamponade after coronary artery bypass surgery
  1. Qiangjun Cai
  1. Cardiology, University of Texas Medical Branch at Galveston, Angleton, Texas, USA
  1. Correspondence to Dr Qiangjun Cai; qiacai{at}utmb.edu

Abstract

Purulent pericarditis caused by Streptococcus anginosus is extremely rare. A 66-year-old man underwent elective coronary artery bypass surgery. This was complicated by sternal wound dehiscence with drainage. Subsequently, he developed fever, progressive dyspnoea and presyncope. Echocardiography showed a large pericardial effusion with evidence of tamponade. He underwent emergent pericardiocentesis. The pericardial fluid culture grew S. anginosus. He was treated with 4 weeks of intravenous ceftriaxone with complete clinical recovery. The source of infection was most likely the sternal wound which was overlooked during debridement and rewiring surgery.

  • pericardial disease
  • ultrasonography

https://doi.org/10.1136/bcr-2020-235862

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    Footnotes

    • Contributors QC: concept/design, acquisition of data, data analysis/interpretation, drafting article, critical revision of article and approval of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.