{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:57:29Z","timestamp":1785344249338,"version":"3.55.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Purulent bacterial pericarditis (PBP) is a highly lethal infection of the pericardial space that arises as a complication of infective illnesses. Purulent bacterial pericarditis remains a diagnostic challenge given its non-specific clinical and investigative features and carries exceedingly high mortality rates due to fulminant sepsis and morbidity including constrictive pericarditis in survivors. We present our management of cardiac tamponade and subsequent constrictive pericarditis due to Actinomyces meyeri PBP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 53-year-old Caucasian male presented with acute New York Heart Association Class IV dyspnoea and chest discomfort, in the context of multiple hospital presentations over the preceding 8 weeks due to presumed recurrent viral pericarditis. On this admission, initial transthoracic echocardiography (TTE) demonstrated a large asymmetric pericardial effusion for which he underwent urgent pericardiocentesis. Serial TTE post-pericardiocentesis, however, demonstrated effusion re-accumulation and effusive-constrictive pericarditis, confirmed on cardiac magnetic resonance imaging. Fluid culture was positive for A. meyeri. He was diagnosed with PBP, but his condition deteriorated despite appropriate intravenous antibiotic therapy, necessitating semi-urgent surgical pericardiectomy. He recovered well and was discharged on Day 10 post-operatively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Unlike uncomplicated acute viral or idiopathic pericarditis, PBP portends a very poor prognosis if unrecognized and untreated. Diagnostic challenges persist given its rarity in modern clinical practice; however, PBP should be considered in cases of seemingly recurrent pericarditis. Multi-modal cardiac imaging and careful analysis of pericardial fluid including cultures and lactate dehydrogenase\/serum ratios may assist in earlier recognition. In this case, source control and symptom relief were achieved only with combined intravenous antibiotics, surgical evacuation, and pericardiectomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac260","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T04:50:56Z","timestamp":1656391856000},"source":"Crossref","is-referenced-by-count":2,"title":["Cardiac tamponade and constrictive pericarditis due to <i>Actinomyces meyeri<\/i> bacterial pericarditis: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7526-2078","authenticated-orcid":false,"given":"Joanne","family":"Eng-Frost","sequence":"first","affiliation":[{"name":"Department of Cardiology, Flinders Medical Centre , Level 6, Flinders Drive, Bedford Park, SA 5042 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Flinders Medical Centre , Level 6, Flinders Drive, Bedford Park, SA 5042 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3128-6147","authenticated-orcid":false,"given":"Scott","family":"Lorensini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Flinders Medical Centre , Level 6, Flinders Drive, Bedford Park, SA 5042 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0636-5639","authenticated-orcid":false,"given":"Rajinder Singh","family":"Harjit-Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Flinders Medical Centre , Level 6, Flinders Drive, Bedford Park, SA 5042 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"2022092914142659800_ytac260-B1","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1016\/0735-1097(93)90592-O","article-title":"Purulent pericarditis: review of a 20-year experience in a general hospital","volume":"22","author":"Sagrista-Sauleda","year":"1993","journal-title":"J Am Coll Cardiol"},{"key":"2022092914142659800_ytac260-B2","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1056\/NEJMoa035630","article-title":"Effusive-constrictive pericarditis","volume":"350","author":"Sagrista-Sauleda","year":"2004","journal-title":"N Engl J Med"},{"key":"2022092914142659800_ytac260-B3","doi-asserted-by":"publisher","first-page":"103","DOI":"10.2165\/00129784-200505020-00004","article-title":"Bacterial pericarditis: diagnosis and management","volume":"5","author":"Pankuweit","year":"2005","journal-title":"Am J Cardiovasc Drugs"},{"key":"2022092914142659800_ytac260-B4","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1097\/01.idc.0000130885.82116.ab","article-title":"Actinomyces meyeri causing tamponade and constrictive pericarditis","volume":"12","author":"Feeney","year":"2004","journal-title":"Infect Dis Clin Pract"},{"key":"2022092914142659800_ytac260-B5","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s40248-018-0132-9","article-title":"Pulmonary actinomycosis attributable to Actinomyces meyeri presenting as cardiac tamponade: a case report","volume":"13:","author":"Nishizawa","year":"2018","journal-title":"Multidiscip Respir Med"},{"key":"2022092914142659800_ytac260-B6","doi-asserted-by":"publisher","first-page":"129","DOI":"10.47102\/annals-acadmedsg.2021485","article-title":"Pericardial effusion and tamponade in a young woman","volume":"51","author":"Wee","year":"2022","journal-title":"Ann Acad Med Singap"},{"key":"2022092914142659800_ytac260-B7","doi-asserted-by":"publisher","first-page":"2410","DOI":"10.1056\/NEJMcp1404070","article-title":"Clinical practice. 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