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Infectious Diseases
Polymicrobial pericarditis caused by bacterial and fungal translocation from an oesophageal ulcer
  1. Michael Holman1,
  2. Greeshma Kambam2,
  3. Coen Lap1 and
  4. Marc O Siegel3
  1. 1 Internal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
  2. 2 The George Washington University Hospital, Washington, District of Columbia, USA
  3. 3 Infectious Diseases, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
  1. Correspondence to Dr Michael Holman; michaelholman30{at}gmail.com

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.

  • Pericardial disease
  • Infectious diseases
  • Oesophagus
  • Endoscopy

https://doi.org/10.1136/bcr-2023-259584

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    Footnotes

    • Contributors All authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. All authors gave final approval of the manuscript.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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