背景:渗出性缩窄性心包炎(ECP)是一种罕见的心包综合征。仔细的超声心动图检查不仅可以为诊断而且可以为管理ECP提供有用的信息。ECP有各种病因;然而,铜绿假单胞菌(P.铜绿假单胞菌)感染迄今尚未报告为原因。在这里,我们介绍了一例罕见的铜绿假单胞菌感染引起的ECP,使用超声心动图进行随访。
方法:一名30岁的男子入院,有2个月的咳嗽史,呼吸困难,腹胀,心悸,和下肢水肿。患者最初通过经胸超声心动图诊断为心包积液。行心包积液引流以缓解临床症状。随访超声心动图显示心包积液减少;然而,右心房压力持续升高,在更全面的检查中观察到缩窄性心包炎的迹象。因此,ECP的诊断是根据心包穿刺术前后的超声心动图检查结果确定的.随后进行了紧急的心包切除术,显着缓解患者的临床症状,超声心动图检查的心包收缩征象得到改善。心包积液和心包培养显示铜绿假单胞菌生长。
结论:铜绿假单胞菌感染引起的ECP仍然是一种罕见的疾病。心包穿刺术治疗后缩窄性心包炎的超声心动图特征的存在高度表明ECP。
BACKGROUND: Effusive-constrictive pericarditis (ECP) is an uncommon pericardial syndrome. Careful echocardiographic examination may provide helpful information not only for diagnosing but also for managing ECP. ECP has various etiologies; however, Pseudomonas aeruginosa (P. aeruginosa) infection has not been reported as a cause to date. Herein, we present a rare case of ECP caused by P. aeruginosa infection, which was followed up using echocardiography.
METHODS: A 30-year-old man was admitted to our hospital with a 2-mo history of cough, dyspnea, bloating, palpitations, and lower-extremity edema. The patient was initially diagnosed with pericardial effusion by transthoracic echocardiography. Drainage of pericardial effusion was performed to relieve the clinical symptoms. A follow-up echocardiogram showed that the pericardial effusion had decreased; however, the right atrial pressure continued to increase, and signs of constrictive pericarditis were observed upon a more comprehensive inspection. Therefore, the diagnosis of ECP was established based on the comprehensive pre- and post-pericardiocentesis echocardiographic findings. An urgent pericardectomy was subsequently performed, which significantly relieved the patient\'s clinical symptoms, and the signs of pericardial constriction on echocardiography improved. Pericardial effusion and pericardial culture showed growth of P. aeruginosa.
CONCLUSIONS: ECP induced by P. aeruginosa infection remains a rare disease. The presence of echocardiographic features of constrictive pericarditis after pericardiocentesis therapy is highly indicative of ECP.