Pyopericarditis and tropical pyomyositis: unusual concomitance

Authors

  • Pedro Henrique Magalhães Craveiro de Melo Divisão de Clínica Médica do Hospital Universitário da Universidade de São Paulo, São Paulo/SP. Brasil
  • Henrique Lane Staniak Divisão de Clínica Médica do Hospital Universitário
  • Aloísio Felipe-Silva Serviço de Anatomia Patológica do Hospital Universitário da USP
  • Itamar Souza Santos Divisão de Clínica Médica do Hospital Universitário da USP
  • Márcio Sommer Bittencourt Divisão de Clínica Médica do Hospital Universitário da USP

DOI:

https://doi.org/10.4322/acr.%25y.26087

Keywords:

Pericarditis, Chest pain, Tropical myositis, Staphylococcus aureus.

Abstract

The authors report a case of a 19-year-old male who presented to the
emergency room complaining of chest pain. His physical examination was
unremarkable, but the EKG showed PR deviation and ST segment elevation.
The patient was diagnosed as probable viral pericarditis and was prescribed
oral anti-inflammatories. After 3 days he returned, complaining of chest pain
worsening, generalized muscle pain and fever. Laboratory examinations
showed creatine kinase isoenzyme MB (CK-MB) = 89.5 ng.mL–1 and C-Reactive
Protein (CRP) = 391 mg.L–1. Echocardiogram showed pericardial thickening
but no pericardial effusion was present. During admission the patient evolved
with cardiac tamponade. Empirical ceftriaxone and oxacillin were started and
the patient underwent pericardial surgical drainage. Staphylococcus aureus
was isolated from the pericardial effusion. After 7 days the patient started
complaining of leg pain, and fever recurred. Computed tomography of the
lower limbs identified large muscle commitment compatible with the presence
abscesses. These findings were suggestive of staphylococcal tropical
myositis. The patient was treated with abscesses drainage and oxacillin. He
was discharged after 18 days to complete oral antibiotic therapy.

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Published

2012-03-30

Issue

Vol. 2 No. 1 (2012)

Section

Article / Clinical Case Report

License

Authors of articles published by Autopsy and Case Report retain the copyright of their work without restrictions, licensing it under the Creative Commons Attribution License - CC-BY, which allows articles to be re-used and re-distributed without restriction, as long as the original work is correctly cited.

How to Cite

Melo, P. H. M. C. de, Staniak, H. L., Felipe-Silva, A., Santos, I. S., & Bittencourt, M. S. (2012). Pyopericarditis and tropical pyomyositis: unusual concomitance. Autopsy and Case Reports, 2(1), 49-53. https://doi.org/10.4322/acr.%y.26087