192 PURULENT PERICARDITIS (PP)–CHANGING ETIOLOGY AND TREATMENT

Abstract

All cases of bacterial pericarditis admitted to Children's Hospital from 1961-1980 were reviewed. To exclude patients with sympathetic pericardial effusion, only cases with pericardial fluid that was culture or CIE positive were analyzed. The organisms that caused PP with median age for each were:

The most common bacterial cause of PP may be shifting from SA to HIB. All children presented with fever and ST-T wave EKG abnormalities. Associated findings for children with SA and HIB were:

All children received antimicrobials. Four children recovered without surgical drainage and 2 recovered after pericardiectomy. Eight children were treated with pericardiotomy with tube drainage. Two of these 8, both of whom had thick pericardial pus, developed constrictive pericarditis requiring total pericardiectomy. One of the two died. The other children have not had evidence of cardiac abnormalities on follow-up evaluations. Patients with thick pericardial pus should undergo pericardiectomy not pericardiotomy.

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