Metropolitan W135 meningococcal compressive pericarditis treated with intrapericardial fibrinolysis

BMJ Case Rep. 2018 Oct 16:2018:bcr2018225080. doi: 10.1136/bcr-2018-225080.

Abstract

Meningococcal pericarditis is a rare but severe form of acute purulent pericarditis. It is a classic complication of Neisseria meningitidis of serotype W135, usually occurring in pilgrims to Mecca and their household contacts. This severe form of meningococcaemia is difficult to diagnose and evolves frequently and gradually towards a tamponade, requiring emergency drainage. We report a case of meningococcal pericarditis caused by N. meningitidis W135 in an immunocompetent patient, without any other organ involvement especially meningeal, requiring pericardium drainage in emergency and then intrapericardial fibrinolysis.

Keywords: adult intensive care; meningitis; pericardial disease.

Publication types

  • Case Reports

MeSH terms

  • Drainage / methods
  • Echocardiography, Transesophageal / methods
  • Fibrinolysis / physiology*
  • Humans
  • Male
  • Meningococcal Infections / microbiology
  • Middle Aged
  • Neisseria meningitidis / isolation & purification*
  • Pericarditis, Constrictive / diagnostic imaging*
  • Pericarditis, Constrictive / drug therapy
  • Pericarditis, Constrictive / microbiology
  • Pericarditis, Constrictive / surgery
  • Pericardium / drug effects
  • Pericardium / microbiology*
  • Pericardium / surgery
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / administration & dosage
  • Urokinase-Type Plasminogen Activator / therapeutic use

Substances

  • Urokinase-Type Plasminogen Activator