Polymicrobial pericarditis caused by bacterial and fungal translocation from an oesophageal ulcer

Document Type

Journal Article

Publication Date

9-3-2024

Journal

BMJ case reports

Volume

17

Issue

9

DOI

10.1136/bcr-2023-259584

Keywords

Endoscopy; Infectious diseases; Oesophagus; Pericardial disease

Abstract

This case report discusses a rare instance of polymicrobial pericarditis in a man in his early 60s with a history of substance abuse. The patient presented with chest pain and shortness of breath, later diagnosed as pericarditis caused by Streptococcus anginosus, S. intermedius and Candida glabrata, likely originating from a large adjacent oesophageal ulcer. The condition led to critical illness, requiring pericardiocentesis, antibiotic and antifungal therapy. Despite initial improvement, the patient experienced recurrence and ultimately underwent pericardectomy. The article emphasises the rarity and severity of polymicrobial pericarditis, often associated with high mortality. It underscores the importance of prompt recognition, broad-spectrum antibiotics and source control, particularly when the gastrointestinal tract is implicated. The case highlights the challenges in managing such cases and the potential need for surgical intervention for optimal outcomes.

Department

Medicine

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