Korean Circ J.  2012 Jul;42(7):501-503. 10.4070/kcj.2012.42.7.501.

Staphylococcus aureus Pericardial Abscess Presenting as Severe Sepsis and Septic Shock After Acupuncture Therapy

• Han WS
• Yoon YJ
• Park CW
• Park SH
• Nam OO
• Rhee I

• KMID: 2094124
• DOI: http://doi.org/10.4070/kcj.2012.42.7.501

Abstract

Pericardial abscess is an extremely rare complication of Staphylococcus aureus bacteremia. We report a case of a 72-year-old woman with multiple acupuncture scars on both knees who presented with shortness of breath and general weakness. Transthoracic echocardiography and pericardiocentesis confirmed the presence of pericardial fluid collection. Staphylococcus aureus grew in both pericardial fluid and blood. Although an aggressive medical treatment including intravenous antibiotics and percutaneous drainage, the patient died 2 days after admission.

Keyword

Staphylococcus aureus; Pericarditis; Acupuncture

MeSH Terms

Abscess
Acupuncture
Acupuncture Therapy
Aged
Anti-Bacterial Agents
Bacteremia
Cicatrix
Drainage
Dyspnea
Echocardiography
Female
Humans
Knee
Pericardiocentesis
Pericarditis
Sepsis
Shock, Septic
Staphylococcus
Staphylococcus aureus
Anti-Bacterial Agents

Figure

• 

  Fig. 1 Serial diagnostic procedures of pericarditis. A: Multiple needle scars on both knees due to acupuncture therapy. B: Transthoracic apical 4-chamber view showing localized pericardial effusion (arrow) posterolateral to the left ventricle. Arrow indicates the lucent region considered to be (and later confirmed as) abscess. C: aspiration fluid showing a bloody material. D: clusters of Gram-positive cocci (Gram stain, ×400, blood).

Reference

1. Mutreja D, Nangia R, Mishra P. Pseudotumoral hepatic tuberculosis with pericardial abscess. Indian J Pathol Microbiol. 2010. 53:763–766.

2. Lin TH, Chiu CC, Huang CH, Tsai KB, Sheu SH. Tuberculous pericardial abscess: a case report. Kaohsiung J Med Sci. 2005. 21:322–325.

3. Van de Donk NW, Meijer RC, America YG, Cramer MJ. Staphylococcus aureus pericardial abscess presenting as a localized bulge of the heart contour. Interact Cardiovasc Thorac Surg. 2010. 10:818–819.

4. Chung HT, Hsieh TC, Yu MC, Chang YS, Lo WC, Jaing TH. Staphylococcus aureus pericardial abscess in a child with beta-thalassemia major following double-unit unrelated cord blood transplantation. Pediatr Hematol Oncol. 2007. 24:275–279.

5. Pérez-Cardona J, Salgado V, Medina-Ruiz A, Quilinchini J, Maldonado A. Pericardial abscess in an intravenous drug user: a case report. P R Health Sci J. 2008. 27:387–389.

6. El-Ahdab F, East M, Sexton D, Bashore T. Staphylococcus aureus pericardial abscess in a patient with liver cirrhosis: case report. South Med J. 2003. 96:926–927.

7. Kim SY, Moon SY, Kim KY, et al. A case of pericardial tamponade in a Korean man with pericardial abscess due to Bacteroides fragilis. Infect Chemother. 2007. 39:314–317.

8. Park JY, Park SA, An YH, et al. A case of tuberculous pericardial abscess mimicking thymic carcinoma. Tuberc Respir Dis. 2011. 70:347–351.