J Korean Soc Echocardiogr.  2000 Dec;8(2):247-251.

A Case of Acute Purulent Pericarditis with Pericardial Performation by Esophageal Foreign Body

• Choi EK
• Kwon KH
• Choi YW
• Oh SK
• Jeong JW
• Park YK

Abstract

Purulent pericarditis is an infrequent but fulminant and frequently lethal disease. Purulent pericarditis tends to occur as direct extension of bacterial pneumonia or empyema in past. In recently, purulent pericarditis tends to occur in adult via contiguous spread from an early postoperative infection after thoracic surgery or trauma, infection related to infective endocarditis, extension from a subdiaphragmatic suppurative source, and hematogenous spread during bacteremia. Endogenous causes of purulent pericarditis are frequently characterized as esophageal perforations. Common causes of esophageal perforations related to purulent pericaditis which usually develop in association with mediastinitis, pneumonia and empyema include corrosive esophagitis, complication after esophageal and tracheal instrumentation and Boerhaave's syndrome. There is very little reference to the development of pericarditis in associated with esophageal perforation which does not directly communicate with the pericardium. while, although most uncommon, it is well documented that the esophagus can perforate directly into the pericardium and produce pericarditis. We experienced a case of acute purulent pericarditis after esophageal and pericardial perforation by a small fish bone in a previously healthy man. The patient was treated successfully with systemic antibiotics and pericardiotomy.

Keyword

Purulent pericarditis; Esophageal perforation; Pericardial perforation

MeSH Terms

Adult
Anti-Bacterial Agents
Bacteremia
Empyema
Endocarditis
Esophageal Perforation
Esophagitis
Esophagus
Foreign Bodies*
Humans
Mediastinitis
Pericardiectomy
Pericarditis*
Pericardium
Pneumonia
Pneumonia, Bacterial
Thoracic Surgery
Anti-Bacterial Agents