Pericarditis - bacterial Health Article

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

• Anxiety
• Chest pain
  • May move (radiate) to the neck, shoulder, back or abdomen
  • Pain increases with breathing
  • Sharp, stabbing
  • Sitting up or standing relieves pain
• Chills
• Difficulty breathing
• Dry cough
• Fatigue
• Fever
• Splinting of ribs with deep breathing (bend over and hold chest when breathing)
• Sweating

Signs and tests

Signs include:

• Faint or far away sounding heart sounds
• Rubbing sound heard when listening to the heart through a stethoscope
• Septic shock
• Signs of fluid in the pericardium (pericardial effusion)
• Signs of fluid in the space around the lungs (pleural effusion), such as decreased breath sounds
• Signs of pneumonia

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

• Chest CT scan
• Chest MRI scan
• Chest x-ray
• Echocardiogram

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:

• Blood cultures
• CBC showing increased WBC count
• Pericardial fluid culture
• Pericardial fluid gram stain