{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:42Z","timestamp":1753876242691,"version":"3.41.2"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013915","name":"Sarnoff Cardiovascular Research Foundation","doi-asserted-by":"publisher","award":["22101"],"award-info":[{"award-number":["22101"]}],"id":[{"id":"10.13039\/100013915","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Acute pericarditis is often caused by viral infections, autoimmune diseases, and radiation therapy (RT). Infectious pericarditis is rare and associated with high morbidity and mortality. We present a case of acute RT-induced pericarditis complicated by bacterial pericarditis and cardiac tamponade due to oesophageal bacterial translocation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 65-year-old man with a recurrent mediastinal sarcoma complicated by oesophageal compression and recent oesophageal stenting presented with shortness of breath. Electrocardiogram showed diffuse ST elevations, and he was diagnosed with presumed RT-induced pericarditis. Despite anti-inflammatory therapy, he developed haemodynamic instability and clinical tamponade, with transthoracic echocardiogram showing a large circumferential pericardial effusion. He underwent emergent pericardiocentesis, and pericardial fluid cultures grew polymicrobial species. Anti-inflammatories were held, and he was started on broad spectrum intravenous antibiotics and antifungals. Due to clinical decompensation and repeat computed tomography imaging demonstrating worsening pericardial disease, he underwent pericardial irrigation and subxiphoid pericardial window. The patient died from hypoxaemic and hypercapnic respiratory failure. Autopsy revealed constrictive pericarditis and no bacterial organisms in the pericardium.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Anti-inflammatories are standard treatment for viral and RT-induced pericarditis. Purulent, bacterial pericarditis is rare and an uncommon complication of RT-induced pericarditis. Polymicrobial infectious pericarditis is often refractory to intravenous antibiotics, requiring surgical intervention. This case highlights the importance of maintaining a high index of suspicion of various potential aetiologies of pericarditis in order to tailor medical and surgical therapies especially in high-risk, immunosuppressed cancer patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae084","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T21:21:37Z","timestamp":1707427297000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute radiation-induced pericarditis complicated by polymicrobial infectious pericarditis in a patient with mediastinal sarcoma: a case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0678-4235","authenticated-orcid":false,"given":"Kimberly L","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Medicine, University of California, San Francisco , 505 Parnassus Ave, San Francisco, CA 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoo Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California, San Francisco , San Francisco, CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-8825","authenticated-orcid":false,"given":"Alan H","family":"Baik","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Francisco , 505 Parnassus Ave, San Francisco, CA 94143, USA"},{"name":"Division of Cardiology, Section of Cardio-Oncology and Immunology, University of California, San Francisco , 555 Mission Bay Blvd South, San Francisco, CA 94158 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"2024022419563365100_ytae084-B1","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jacc.2019.11.021","article-title":"Management of acute and recurrent pericarditis: JACC state-of-the-art review","volume":"75","author":"Chiabrando","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2024022419563365100_ytae084-B2","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/0002-9343(77)90150-4","article-title":"The changed spectrum of purulent pericarditis: an 86 year autopsy experience in 200 patients","volume":"63","author":"Klacsmann","year":"1977","journal-title":"Am J Med"},{"key":"2024022419563365100_ytae084-B3","doi-asserted-by":"crossref","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":"2024022419563365100_ytae084-B4","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1200\/JCO.2016.70.0229","article-title":"Cardiac toxicity after radiotherapy for stage III non-small-cell lung cancer: pooled analysis of dose-escalation trials delivering 70 to 90 Gy","volume":"35","author":"Wang","year":"2017","journal-title":"J Clin Oncol"},{"key":"2024022419563365100_ytae084-B5","doi-asserted-by":"crossref","first-page":"39","DOI":"10.3389\/fonc.2015.00039","article-title":"Radiation-induced heart disease: pathologic abnormalities and putative mechanisms","volume":"5","author":"Taunk","year":"2015","journal-title":"Front Oncol"},{"key":"2024022419563365100_ytae084-B6","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S1010-7940(03)00500-1","article-title":"Purulent pericarditis caused by malignant oesophago-pericardial fistula","volume":"24","author":"Touati","year":"2003","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024022419563365100_ytae084-B7","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/S1010-7940(01)01027-2","article-title":"Delayed diagnosis of purulent pericarditis caused by esophagopericardial fistula by computed tomography scan and echocardiography","volume":"20","author":"Choi","year":"2001","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024022419563365100_ytae084-B8","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1093\/eurheartj\/ehv318","article-title":"2015 ESC guidelines for the diagnosis and management of pericardial diseases: the task force for the diagnosis and management of pericardial diseases of the European Society of Cardiology (ESC) endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"36","author":"Adler","year":"2015","journal-title":"Eur Heart J"},{"key":"2024022419563365100_ytae084-B9","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1161\/CIRCULATIONAHA.111.018580","article-title":"Risk of constrictive pericarditis after acute pericarditis","volume":"124","author":"Imazio","year":"2011","journal-title":"Circulation"}],"container-title":["European Heart Journal - 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