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Purulent Pericarditis and Mediastinitis due to Peptococcus magnus

Purulent Pericarditis and Mediastinitis due to Peptococcus magnus PURULENT pericarditis and atraumatic mediastinitis are both uncommon illnesses. We report herein a case with both infections due to Peptococcus magnus, a pathogen reported only rarely1,2 as the cause of either infection. The source of infection was probably an occult tooth abscess. Report of a Case A 30-year-old man was admitted elsewhere after two weeks of progressive fever, pleuritic chest pain, cough, and dyspnea. Examination disclosed fever and findings of pericardial tamponade. A chest roentgenogram showed cardiomegaly, and an echocardiogram showed normal valves and a large pericardial effusion. Pericardiocentesis was performed, with removal of 10 mL of purulent fluid. Examination of the fluid revealed 67,000 white blood cells (89% polymorphonuclear leukocytes) and gram-positive cocci. Blood cultures were not obtained. Therapy with nafcillin sodium and tobramycin was begun, and clindamycin was added when only anaerobic cultures yielded organisms. Biochemical identification of the pathogen as P magnus and persistent fever prompted http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Purulent Pericarditis and Mediastinitis due to Peptococcus magnus

JAMA , Volume 254 (7) – Aug 16, 1985

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1985.03360070085029
Publisher site
See Article on Publisher Site

Abstract

PURULENT pericarditis and atraumatic mediastinitis are both uncommon illnesses. We report herein a case with both infections due to Peptococcus magnus, a pathogen reported only rarely1,2 as the cause of either infection. The source of infection was probably an occult tooth abscess. Report of a Case A 30-year-old man was admitted elsewhere after two weeks of progressive fever, pleuritic chest pain, cough, and dyspnea. Examination disclosed fever and findings of pericardial tamponade. A chest roentgenogram showed cardiomegaly, and an echocardiogram showed normal valves and a large pericardial effusion. Pericardiocentesis was performed, with removal of 10 mL of purulent fluid. Examination of the fluid revealed 67,000 white blood cells (89% polymorphonuclear leukocytes) and gram-positive cocci. Blood cultures were not obtained. Therapy with nafcillin sodium and tobramycin was begun, and clindamycin was added when only anaerobic cultures yielded organisms. Biochemical identification of the pathogen as P magnus and persistent fever prompted

Journal

JAMAAmerican Medical Association

Published: Aug 16, 1985

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