Emergency centre diagnosis and treatment of purulent pericarditis: A case report from Tanzania.

Journal: African journal of emergency medicine : Revue africaine de la medecine d'urgence

Volume: 8

Issue: 1

Year of Publication: 

Affiliated Institutions:  Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Emergency Medicine, University of California, San Francisco, CA, USA.

Abstract summary 

Purulent pericarditis poses diagnostic and therapeutic challenges, especially in resource-limited settings due to the unavailability of diagnostic tools, equipment, and expertise.A three-year-old female presented to the emergency centre at Muhimbili National Hospital in Dar es Salaam, Tanzania with altered mental status, lethargy, intermittent fevers, worsening difficulty in breathing, and progressive lower extremity swelling over two months. The child was in shock upon arrival. Point-of-care ultrasound demonstrated cardiac tamponade secondary to purulent pericarditis. An ultrasound guided pericardiocentesis and lavage was successfully done in the emergency centre and antibiotics were started. Though definitive management (pericardiectomy) was delayed, the child survived to hospital discharge.Pericardiocentesis, pericardial lavage, and the initiation of broad spectrum antibiotics are the mainstay of early treatment of purulent pericarditis. This treatment can be done safely in an emergency centre with little specialised equipment aside from point-of-care ultrasound.

Authors & Co-authors:  Shari Catherine R CR Sawe Hendry R HR Davey Kevin K Murray Brittany L BL

Study Outcome 

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Statistics
Citations :  Pankuweit S., Ristić A.D., Seferović P.M. Bacterial pericarditis: diagnosis and management. Am J Cardiovasc Drugs Drugs Devices Interv. 2005;5(2):103–112.
Authors :  4
Identifiers
Doi : 10.1016/j.afjem.2017.12.002
SSN : 2211-4203
Study Population
Female
Mesh Terms
Other Terms
Emergency department;Pediatrics;Pericarditis;Tanzania
Study Design
Case Study
Study Approach
Country of Study
Tanzania
Publication Country
Netherlands