piperacillin--tazobactam-drug-combination and Rheumatic-Heart-Disease

Constrictive pericarditis is a relatively uncommon form of cardiac failure and presents due to scarring and consequent loss of the normal elasticity of the pericardial sac. This results in abnormal/limited ventricular filling and symptoms of heart failure. The aetiology is varied, from infective causes to idiopathic causes, or can manifest after cardiothoracic surgery. This case involves a 46-year-old man presenting with acute group A beta haemolytic streptococcus infection, and over the subsequent 6 months develops constrictive pericarditis due to what is believed to be a rheumatic aetiology. The patient subsequently underwent pericardiectomy and had restoration of normal filling dynamics confirmed on follow-up echocardiography. This case provides a subject matter for the review of the features of constrictive pericarditis and its investigation and management. This case is that it highlights the fact that pericarditis is not a benign condition. Emerging evidence suggests that pericarditis is due to a failure in inflammatory regulatory mechanisms, and patients suffering this condition have a preponderance to 'autoinflammation'. Pericarditis should be recognised early and treated fully with anti-inflammatory agents.

Topics: Anti-Bacterial Agents; Antistreptolysin; Bacteremia; Blood Culture; C-Reactive Protein; Cardiac Catheterization; Ceftriaxone; Electrocardiography; Hospitalization; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pericardiectomy; Pericarditis, Constrictive; Piperacillin, Tazobactam Drug Combination; Rheumatic Heart Disease; Streptococcal Infections; Streptococcus pyogenes; Ventricular Pressure