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Background: Purulent pericarditis is an infectious condition characterized by purulent pericardial effusion.
Case Presentation: In this case report, we present a 60-year-old male admitted with intermittent chest pain and fever, ultimately diagnosed with primary purulent pericarditis. Imaging revealed an eccentric loculated pericardial effusion, posing significant challenges for conventional pericardiocentesis. In this context, we innovatively employed a percutaneous transluminal coronary angioplasty (PTCA) guidewire-based pericardiocentesis technique, achieving successful catheter placement followed by intrapericardial administration of 5 mg alteplase. During follow-up, the patient achieved complete clinical recovery.
Conclusions: This report introduces a PTCA guidewire-based pericardiocentesis approach, which safely addresses complex eccentric loculated pericardial effusions. Combined with low-dose intrapericardial alteplase, drainage efficacy was enhanced, pericardial adhesions were reduced, and invasive pericardiectomy could be avoided. This minimally invasive technique provides a viable alternative to surgery for high-risk patients.
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http://dx.doi.org/10.3389/fcvm.2025.1660781 | DOI Listing |
Cureus
August 2025
Internal Medicine, Aster Hospital, Dubai, ARE.
This case report describes primary meningococcal pericarditis (PMP), a rare and potentially life-threatening form of infection that may mimic idiopathic or viral pericarditis, particularly in the absence of classic signs of meningococcemia or meningitis. PMP accounts for a small proportion of meningococcal pericarditis cases. Early in its course, PMP can present without systemic features or hemodynamic instability, complicating timely recognition.
View Article and Find Full Text PDFJ Cancer Res Ther
September 2025
Department of Gynaecology and Obstetrics, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Esophageal pericardial fistula is a rare complication of esophageal cancer. This article reports the first documented case of an esophageal pericardial fistula following radiotherapy in the presence of an esophageal stent. A 62-year-old man with advanced esophageal and cardiac cancer underwent radiotherapy after esophageal stent placement and subsequently developed an esophageal pericardial fistula.
View Article and Find Full Text PDFWorld J Clin Cases
September 2025
Department of Internal Medicine, University of Nebraska College of Medicine, Omaha, NE 68198, United States.
Background: Pericarditis is the inflammation of the pericardial sac due to a variety of stimuli that ultimately trigger a stereotyped immune response. This condition accounts for up to 5% of emergency department visits for nonischemic chest pain in Western Europe and North America. The most common symptoms of clinical presentation are chest pain and shortness of breath with associated unique electrocardiographic changes.
View Article and Find Full Text PDFCase Rep Cardiol
August 2025
Department of Interventional Cardiology, Marshall University, Huntington, West Virginia, USA.
Purulent pericarditis is a rare, life-threatening condition that has become exceedingly uncommon due to widespread use of antibiotics. However, immunocompromised patients remain susceptible to such opportunistic infections. It is typically caused by direct extension or hematogenous spread from a secondary bacterial source.
View Article and Find Full Text PDFFront Cardiovasc Med
August 2025
Department of Cardiovascular Medicine, Cardiovascular Research Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background: Purulent pericarditis is an infectious condition characterized by purulent pericardial effusion.
Case Presentation: In this case report, we present a 60-year-old male admitted with intermittent chest pain and fever, ultimately diagnosed with primary purulent pericarditis. Imaging revealed an eccentric loculated pericardial effusion, posing significant challenges for conventional pericardiocentesis.