Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7577
Peer-review started: February 18, 2022
First decision: March 24, 2022
Revised: April 5, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: July 26, 2022
Processing time: 143 Days and 6.7 Hours
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.
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.
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.
Core Tip: Effusive-constrictive pericarditis (ECP) is an uncommon clinical syndrome with varied causes, and Pseudomonas aeruginosa (P. aeruginosa) infection is an extremely rare etiology of ECP. This report presents a rare case of P. aeruginosa -induced ECP that was diagnosed based on comprehensive post-pericardiocentesis follow-up echocardiography. The patient was initially misdiagnosed with pure pericardial effusion. This emphasizes the importance of sensitive identification of ECP echocardiographic features and the advantage of follow-up echocardiography after pericardiocentesis for the diagnosis and treatment of ECP.