Diagnosis
Infections of the pericardium and the pericardial space with fevers, chest pain, diffuse ST and PR changes on EKG, signs of cardiac tamponade; echocardiogram will aid in making the diagnosis.
Epidemiologic Risks
It depends on the organism: if infectious it is usually either hematogenous or direct extension. There is an idiopathic recurrent form of the disease.
Microbiology
While any organism can cause pericarditis, here are some common and/or interesting causes:
Viral: enterovirus (Coxsackie B).
Bacterial: S. pneumonia, S. aureus.
Mycobacterial: MTb.
Fungal: Histoplasmosis.
Parasite: E. histolytica (liver abscess ruptures into the pericardium).
Empiric Therapy
Acute pyogenic pericarditis usually requires emergent drainage plus antibiotics. Nafcillin/oxacillin OR vancomycin PLUS third-generation cephalosporins.
Chronic disease depends on the clinical suspicion.
Idiopathic relapsing responds to colchicine (PubMed) as does acute pericarditis at a dose of 0.5 mg bid for 3 months for patients weighing >70 kg or 0.5 mg qd for patients weighing ≤70 kg (PubMed).
Curious Cases
Relevant links to my Medscape blog
Last Update: 12/19/18.