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Purulent pericardial effusion in children: Experience from a tertiary care center in North India

BACKGROUND: Purulent pericarditis, if not recognized and managed timely, it can lead to significant morbidity and mortality. There are no guidelines for the management of purulent pericardial effusion in pediatric patients. AIM: The study describes our experience with the management of 22 patients a...

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Autores principales: Agrawal, Anika, Jhamb, Urmila, Nigam, Arima, Agrwal, Shipra, Saxena, Romit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727893/
https://www.ncbi.nlm.nih.gov/pubmed/33311916
http://dx.doi.org/10.4103/apc.APC_125_19
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author Agrawal, Anika
Jhamb, Urmila
Nigam, Arima
Agrwal, Shipra
Saxena, Romit
author_facet Agrawal, Anika
Jhamb, Urmila
Nigam, Arima
Agrwal, Shipra
Saxena, Romit
author_sort Agrawal, Anika
collection PubMed
description BACKGROUND: Purulent pericarditis, if not recognized and managed timely, it can lead to significant morbidity and mortality. There are no guidelines for the management of purulent pericardial effusion in pediatric patients. AIM: The study describes our experience with the management of 22 patients admitted with a primary diagnosis of purulent pericardial effusion seen over a 7-year period. MATERIALS AND METHODS: Hospital records of 22 children admitted to the pediatric intensive care unit with purulent pericardial effusion during January 2012–December 2018 were retrospectively analyzed. RESULTS: The mean age of presentation was 4.6 years. The most common presentation was fever. History of antecedent trauma was present in 27.27% of patients. Empyema was the most common associated infection. Staphylococcus aureus was the most commonly isolated organism. Out of 22, pericardial drainage was done in 13 patients (59%). Only one of these patients required pericardiectomy later on. Six (27.2%) patients responded to antibiotics alone. Three (13.6%) patients died before any intervention could be planned. CONCLUSION: Echocardiography-guided percutaneous pericardiocentesis and pigtail catheter placement are a safe and effective treatment for purulent pericardial effusion. When pericardial drainage is not amenable, close monitoring of the size of effusion by serial echocardiography is required. Small residual pericardial effusion may be managed conservatively.
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spelling pubmed-77278932020-12-11 Purulent pericardial effusion in children: Experience from a tertiary care center in North India Agrawal, Anika Jhamb, Urmila Nigam, Arima Agrwal, Shipra Saxena, Romit Ann Pediatr Cardiol Original Article BACKGROUND: Purulent pericarditis, if not recognized and managed timely, it can lead to significant morbidity and mortality. There are no guidelines for the management of purulent pericardial effusion in pediatric patients. AIM: The study describes our experience with the management of 22 patients admitted with a primary diagnosis of purulent pericardial effusion seen over a 7-year period. MATERIALS AND METHODS: Hospital records of 22 children admitted to the pediatric intensive care unit with purulent pericardial effusion during January 2012–December 2018 were retrospectively analyzed. RESULTS: The mean age of presentation was 4.6 years. The most common presentation was fever. History of antecedent trauma was present in 27.27% of patients. Empyema was the most common associated infection. Staphylococcus aureus was the most commonly isolated organism. Out of 22, pericardial drainage was done in 13 patients (59%). Only one of these patients required pericardiectomy later on. Six (27.2%) patients responded to antibiotics alone. Three (13.6%) patients died before any intervention could be planned. CONCLUSION: Echocardiography-guided percutaneous pericardiocentesis and pigtail catheter placement are a safe and effective treatment for purulent pericardial effusion. When pericardial drainage is not amenable, close monitoring of the size of effusion by serial echocardiography is required. Small residual pericardial effusion may be managed conservatively. Wolters Kluwer - Medknow 2020 2020-07-24 /pmc/articles/PMC7727893/ /pubmed/33311916 http://dx.doi.org/10.4103/apc.APC_125_19 Text en Copyright: © 2020 Annals of Pediatric Cardiology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Agrawal, Anika
Jhamb, Urmila
Nigam, Arima
Agrwal, Shipra
Saxena, Romit
Purulent pericardial effusion in children: Experience from a tertiary care center in North India
title Purulent pericardial effusion in children: Experience from a tertiary care center in North India
title_full Purulent pericardial effusion in children: Experience from a tertiary care center in North India
title_fullStr Purulent pericardial effusion in children: Experience from a tertiary care center in North India
title_full_unstemmed Purulent pericardial effusion in children: Experience from a tertiary care center in North India
title_short Purulent pericardial effusion in children: Experience from a tertiary care center in North India
title_sort purulent pericardial effusion in children: experience from a tertiary care center in north india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727893/
https://www.ncbi.nlm.nih.gov/pubmed/33311916
http://dx.doi.org/10.4103/apc.APC_125_19
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