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Heart, section through the middle
Heart, section through the middle


Heart, front view
Heart, front view


Pericardium
Pericardium


Bacterial pericarditis
Bacterial pericarditis


Definition:

Bacterial pericarditis is irritation and swelling of the sac that surrounds the heart (pericardium), due to infection by bacteria.

See also: Pericarditis



Alternative Names:

Purulent pericarditis



Causes, incidence, and risk factors:

Bacterial infections are one cause of pericarditis . Since the introduction of antibiotics, bacterial pericarditis has become rare.

It most often occurs in men between the ages of 20 and 50, usually after some type of respiratory infection. It can also occur after skin or mouth infections that produce bacterial infection of the blood (bacteremia) and after heart surgery.

The bacterial infection causes the pericardium to become swollen and inflamed. Pain occurs as a result of the inflamed pericardium rubbing against the heart. Fluid may build up in the pericardial sac.

The most common bacteria that cause this condition are:

  • Haemophilus influenza (also called H.flu)
  • Meningococci
  • Pneumococci
  • Staphylococci
  • Streptococci


Symptoms:

Signs and tests:

Signs include:

Doctors may suspect pericarditis when one of the following tests shows an abnormal amount of fluid in the pericardial sac:

This condition is diagnosed when the fluid around the pericardial sac is shown to be infected with bacteria. The following tests help doctors make this diagnosis:



Treatment:

The goal of treatment is to cure the infection.

Medications include:

  • Antibiotics to treat bacterial infections
  • Analgesics to relieve pain
  • Aspirin, ibuprofen, or other nonsteroidal anti-inflammatory medications (NSAIDS) to relieve inflammation of the pericardium
  • Diuretics to remove excess fluid

Bedrest with the head of the bed raised may reduce the workload on the heart.

Other treatments include:

  • Cutting a small hole (window) in the pericardium (subxiphoid pericardiotomy) to allow infected fluid to drain
  • Draining fluid from the pericardial sac (pericardiocentesis ) to prevent or treat cardiac tamponade
  • Pericardial stripping or removing part of the pericardium (surgical pericardiectomy) if bacterial pericarditis is chronic or comes back


Support Groups:



Expectations (prognosis):

The disorder may be life-threatening if untreated. The outcome is good if bacterial pericarditis is treated promptly. Most people recover completely with treatment.



Complications:

Calling your health care provider:



Prevention:



References:

LeWinter MM. Pericardial Diseases. In: Libby P, Bonow RO, Mann DL, Zipes DP. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 70.




Review Date: 5/15/2008
Reviewed By: Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100