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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2011 October;170(5):353-7

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

A case of purulent pericarditis caused by Haemophilus influenzae serotype b

Zangari P. 1, Santilli A. 2, Santilli V. 1, Cotugno N. 1, Calò Carducci F. I. 1, D’Argenio P. 1

¹ DPUO, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy ² Department of Cardiology, Pediatric Hospital Bambino Gesù, Rome, Italy


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Purulent pericarditis is a rare but life-threatening cardiac emergency. The epidemiology and infectious etiology of the illness changed over time because of prevention and therapeutic strategies. Today isolation of Haemophilus influenzae serotype b (Hib) from the pericardial space is rarely observed. After the widespread of antibiotics and introduction of Hib conjugate immunization in industrialized countries the annual incidence of Hib invasive diseases has greatly decreased from 4.78/100 000 persons to 0.44/100 000 persons among children aged <5 years. Despite these data a low immunization coverage subsists among people with a poor socioeconomic status, in particular itinerant populations such as Roma. We report a case of acute pericarditis progressing to cardiac tamponade caused by Hib in a not immunized 17 months old girl who came from a Roma community. Tamponade was suspected on the basis of clinical, radiological and echographic signs. We treated the patient with intravenous antibiotic therapy and pericardiocentesis with successful results. Surgical approach to purulent pericarditis is still debated. The aim of this case report was to discuss about the treatment of purulent pericarditis and the widespread of rare diseases for which exists an immunization coverage, among some groups of the population.

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