Purulent pericarditis caused by the Streptococcus milleri group: a case report and review of the literature.

A 69-year-old woman with a history of diabetes mellitus presented at our emergency room with chest pain and dyspnea. A chest computed tomography revealed a pericardial effusion. Pericardiocentesis was performed; strains of the Streptococcus milleri group were detected on culture of the fluid thus obtained. Therefore, purulent pericarditis was diagnosed. Despite treatment with panipenem/betamipron, the pericarditis worsened leading to the development of cardiac tamponade. Emergency pericardial drainage was performed, after which the condition resolved without any complications. We report an extremely rare case of purulent pericarditis caused by a strain of the Streptococcus milleri group. In addition, we review 5 previously reported cases of purulent pericarditis caused by strains.

[1]  E. Hak,et al.  Usefulness of consecutive C-reactive protein measurements in follow-up of severe community-acquired pneumonia. , 2009, Revista portuguesa de pneumologia.

[2]  P Andrew Sleigh,et al.  Aerial Dissemination of Clostridium difficile spores , 2008, BMC infectious diseases.

[3]  M. Tikly,et al.  Purulent pericarditis due to co-infection with Streptococcus pneumoniae and Mycobacterium tuberculosis in a patient with features of advanced HIV infection , 2007, BMC infectious diseases.

[4]  S. Morita,et al.  Infective endocarditis and acute purulent pericarditis in a patient with hyperglycemia. , 2005, Internal medicine.

[5]  A. El‐Solh,et al.  Etiology of severe pneumonia in the very elderly. , 2001, American journal of respiratory and critical care medicine.

[6]  H. De Baere,et al.  Streptococcus Milleri, A Rare Cause Of Pericarditis; Successful Treatment by Pericardiocentesis Combined With Parenteral Antibiotics , 2000, Acta clinica Belgica.

[7]  T. Alarcón,et al.  Five-Year Analysis of Antimicrobial Susceptibility of the Streptococcusmilleri Group , 1999, European Journal of Clinical Microbiology and Infectious Diseases.

[8]  H. Tajiri,et al.  Streptococcus milleri infection and pericardial abscess associated with esophageal carcinoma: report of two cases. , 1999, Hepato-gastroenterology.

[9]  M. Salavert,et al.  Thoracic infection caused by Streptococcus milleri. , 1998, The European respiratory journal.

[10]  J. M. Lipton,et al.  Cytokine antagonists in aged subjects and their relation with cellular immunity. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  E. Houang,et al.  Species identification of members of the Streptococcus milleri group isolated from the vagina by ID 32 Strep system and differential phenotypic characteristics , 1995, Journal of clinical microbiology.

[12]  H. Asato,et al.  A case of effusive constrictive pericarditis caused by Streptococcus milleri. , 1991, Japanese circulation journal.

[13]  D. Beighton,et al.  Phenotypic differentiation of Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus strains within the "Streptococcus milleri group" , 1990, Journal of clinical microbiology.

[14]  K. Akashi,et al.  Purulent pericarditis caused by Streptococcus milleri. , 1988, Archives of internal medicine.

[15]  N. Sinzobahamvya,et al.  Purulent pericarditis. , 1987, Archives of disease in childhood.

[16]  J. Dussek,et al.  Streptococcus milleri as a cause of pleural empyema. , 1985, Thorax.

[17]  H. S. Klopfenstein,et al.  Right ventricular and right atrial collapse in patients with cardiac tamponade--a combined echocardiographic and hemodynamic study. , 1984, Circulation.

[18]  P. M. Poole,et al.  Occurrence and cultural features of Streptococcus milleri in various body sites. , 1979, Journal of clinical pathology.

[19]  John E. Bennett,et al.  Principles and practice of infectious diseases. Vols 1 and 2. , 1979 .

[20]  R. Lancefield.  A SEROLOGICAL DIFFERENTIATION OF HUMAN AND OTHER GROUPS OF HEMOLYTIC STREPTOCOCCI , 1933, The Journal of experimental medicine.