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44-jähriger Patient mit kulturnegativer, purulenter Perikarditis

Culture-negative, purulent pericarditis

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Zusammenfassung

Wir berichten über einen Patienten mit purulenter Perikarditis und drohender Perikardtamponade, verursacht durch Neisseria meningitidis. Bei negativen Kulturen aus Blut und Perikardpunktat, wahrscheinlich bedingt durch die Vorbehandlung mit Antibiotika, konnten wir mittels Breitspektrumpolymerasekettenreaktion aus dem Perikardpunktat und einem Latexagglutinationstest aus Pleurapunktat Meningokokken der Serogruppe C nachweisen. Eine Meningokokkenperikarditis ohne Meningitis ist selten. Diagnostische Methoden auf nicht-kultureller Basis spielen bei Patienten, die bereits mit Antibiotika vorbehandelt sind, eine wichtige Rolle.

Abstract

We report about a patient with purulent pericarditis due to Neisseria meningitidis pretreated with antibiotics. Clinical signs were suggestive of pericardial tamponade. Cultures from blood and pericardial aspirate remained negative. Broad-range polymerase chain reaction from pericardial fluid detected Neisseria sp.. Latex agglutination assay from pleural fluid showed positive reaction with meningococcal antigen serogroup C. Meningococcal pericarditis without meningitis is a rare manifestation. Non-culture based diagnostic methods in patients with such severe infections and negative cultures play an important role.

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Dank

Wir danken Herrn Prof. Manuel Battegay für die kritische Durchsicht.

Interessenkonflikt

Die Autoren bestätigen, dass im Zusammenhang mit diesem Beitrag keine Interessenkonflikte vorliegen.

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Authors and Affiliations

  1. Klinik für Infektiologie & Spitalhygiene, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz

    D. Vuichard & M. Weisser

  2. Kardiologische Klinik, Universitätsspital Basel, Basel, Schweiz

    M.J. Zellweger

  3. Bio-Analytica AG, Luzern, Schweiz

    M. Altwegg

  4. Abteilung für Klinische Mikrobiologie, Universitätsspital Basel, Basel, Schweiz

    R. Frei

Authors
  1. D. Vuichard
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  2. M.J. Zellweger
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  3. M. Altwegg
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  4. R. Frei
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  5. M. Weisser
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Corresponding author

Correspondence to D. Vuichard.

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Vuichard, D., Zellweger, M., Altwegg, M. et al. 44-jähriger Patient mit kulturnegativer, purulenter Perikarditis. Internist 52, 889–893 (2011). https://doi.org/10.1007/s00108-010-2742-y

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  • DOI: https://doi.org/10.1007/s00108-010-2742-y

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