ANAEROBIC PERICARDITIS - CASE-REPORT AND REVIEW

Purulent pericarditis is uncommon and is rarely caused by anaerobic ba cteria. We describe a 58-year-old man with purulent pericarditis secon dary to infection with bacteriodes fragilis; the most likely source fo r the B. fragilis infection was subsequently found to be a ruptured ap pendix. His pericarditis eventually resolved after drainage of purulen t fluid and treatment with antibiotics directed against B. fragilis. W e also review 29 cases of anaerobic pericarditis previously reported i n the English-language literature (we excluded those cases due to acti nomyces). In 17 cases only anaerobic bacteria were isolated, while in 13 anaerobes were isolated with a mixture of facultative and/or aerobi c bacteria. The cases were secondary to a contiguous focus of infectio n or occurred via hematogenous seeding. Treatment of both anaerobic pe ricarditis and purulent pericarditis due to aerobic bacteria entails a dequate drainage and appropriate antibiotic therapy, and in all cases there should be a search for the source of the organism infecting the pericardium.