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Purulent pericarditis, multi‐site abscesses and ketoacidosis in a patient with newly diagnosed diabetes: a rare case report
Author(s) -
Lee H.H.,
Chu C.Y.,
Su H.M.,
Lin T.H.,
Voon W.C.,
Lai W.T.,
Sheu S.H.,
Hsu P.C.
Publication year - 2014
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12458
Subject(s) - medicine , pericardiocentesis , pericardiectomy , diabetic ketoacidosis , pericarditis , surgery , fulminant , complication , diabetes mellitus , pericardial effusion , endocrinology
Background Purulent pericarditis is an acute and fulminant disease characterized by pus accumulation in the pericardial space. Its incidence has declined substantially and the common pathogen has changed since the beginning of the antibiotic era; however, it is still found in some patients with immunocompromised conditions. Case report We report a rare case in which the onset of diabetes mellitus presented as extremely high HbA 1c concentration, ketoacidosis, multi‐site abscesses and purulent pericarditis. After antibiotic therapy and pericardiocentesis, the purulent pericarditis still did not resolve and further intrapericardial thrombolytic therapy also failed. Finally, this patient was treated successfully by surgical debridement and pericardiectomy. Conclusion In the immunocompromised state of severe hyperglycaemia, purulent pericarditis is a possible complication of uncontrolled infection. If purulent pericarditis cannot be cured using non‐surgical treatments, such as antibiotic therapy, pericardiocentesis and intrapericardial thrombolytic therapy, a surgical pericardiectomy should be considered to avoid morbidity and mortality.