Fusobacterium Pericarditis in a child: A case report
Abstract
- Background:
- a) Pericarditis incidence:
- b) Pericarditis etiology:
- c) Anaerobic bacteria as etiology for fusobacterium: A genus of anaerobic, gram-negative rods that commonly colonizes the oropharynx. Can cause pharyngitis, dental infections, deep neck space infections, and aspiration pneumonia. Species include F. necrophorum and F. nucleatum. Fusobacterium is ubiquitous in the normal flora of the oropharyngeal, gastrointestinal, and genitourinary tracts of healthy humans
- d) Scarcity of fusobacterium in peds: Pericardial involvement with fusobacterium in children is an infrequent occurrence.
- e) Reported case of:
- Case report
A previously healthy 12 years old male presents with a 2-month history of fever, cough and malaise, recently discharged from PICU with a diagnosis of viral pericarditis. Due to persistent fevers, patient is directly admitted from cardiology clinic for further work up.
HPI: 2 months ago patient presented with cough, congestion and daily fever of 103, fever are nocturnal associated with drenching sweatis and resolved in the morning. No more than 2 days without fever episode. Was initially diagnosed with bronchitis and acute otitis media at an urgent care clinic and was treated with antibiotics. Night prior to admission he had severe leg cramping and left shoulder pain, that was not present on the admission date. Patient had increasing sob with exertion or walking up a stairs. He also had difficulty breathing while lying flat and used to sleep incline using 3 pillows. He has been wheezing, but stated, albuterol has not helped his sob. Patient was tken to the ED that day due to cough and CXR was read as heart failure. An Echo was done and patient was admitted to the PICU. He was diagnosed with pericarditis on echo. CBC showed mild anemia (hemoglobin of 9) esr of 100, normal BMP and normal renal function, BN P2 126, CRP more than 18, negative rheumatoid factor, ANA, strep tes, respiratory panel (parainfluenza, influenzas, rsv) negative quantiferon gold, procalcitonin less than 0.05. Treatment for pericarditis with scheduled NSAIds and PPI was begun. A repeat echo the next day was stable, patient was discharge home on pantoprazole and ibuprofen 600mg every 6 hours.
- Discussion
- Pericarditis due to anaerobes
-Fusobacterium pericarditis (pathogenesis)
-Hypothesis about pathogenesis in our patient
- Purulent pericarditis
-Available literature
- Management of pericarditis patient and rationale
- Conclusion