Purulent pericarditis: clinical profile and outcome following surgical drainage and intensive care in children in Chandigarh

Purulent pericarditis, though rare in developed countries, is not uncommon in developing countries. However, the type of pericardial drainage required and the risk of subsequent constrictive pericarditis has not been clearly defined. Thirty children between the ages of 3 months and 12 years with a d iagnosis of purulent pericarditis were studied retrospectively. Pericardial effusion was confirmed in all by echocardiography and the diagnosis of bac terial pericarditis was based on aspiration of purulent fluid with leucocyt osis and high proteins. Purulent pericarditis was a part of the disseminate d sepsis in 25 (83%) children. Fever was present in all, hepatomegaly in 28 and breathlessness in 25, whereas muffled heart sounds, raised JVP and per icardial rub were found in only 18, 16 and 7, respectively. The ECG was abn ormal in only 16 children. Staphylococcus aureus was the causative organism in 24 (96%). Open surgical drainage was done in 26 children, 23 of whom un derwent anterior pericardiectomy, Two children died of disseminated sepsis. None of the 21 who returned for follow-up for periods of between 4 and 24 months had any long-term sequelae.