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* Bacterial pericarditis<ref name="pmid15120056">{{cite journal| author=Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y et al.| title=Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. | journal=Eur Heart J | year= 2004 | volume= 25 | issue= 7 | pages= 587-610 | pmid=15120056 | doi=10.1016/j.ehj.2004.02.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15120056 }}</ref><ref>{{Cite journal| issn = 1175-3277| volume = 5| issue = 2| pages = 103–112| last1 = Pankuweit| first1 = Sabine| last2 = Ristić| first2 = Arsen D.| last3 = Seferović| first3 = Petar M.| last4 = Maisch| first4 = Bernhard| title = Bacterial pericarditis: diagnosis and management| journal = American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions| date = 2005| pmid = 15725041}}</ref><ref>{{Cite journal| issn = 1092-8464| volume = 2| issue = 4| pages = 343–350| last = Goodman| first = null| title = Purulent Pericarditis| journal = Current Treatment Options in Cardiovascular Medicine| date = 2000-08| pmid = 11096539}}</ref> | |||
:* '''Purulent pericarditis with contiguous pneumonia''' | |||
::* Preferred regimen: [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL {{and}} ([[Ceftriaxone]] 1–2 g IV q12h {{or}} [[Cefotaxime]] 2 g IV q6–8h) {{and}} ([[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Levofloxacin]] 500–750 mg IV q24h) | |||
:* '''Purulent pericarditis with contiguous head and neck infection''' | |||
::* Preferred regimen: [[Imipenem]] 500 mg IV q6–8h {{or}} [[Ampicillin-Sulbactam]] 3 g IV q6h | |||
:* '''Purulent pericarditis secondary to infective endocarditis''' | |||
::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h targeting trough levels of 15–20 μg/mL {{and}} [[Gentamicin]] 3 mg/kg/day IV q8–12h | |||
::: Note: [[Pericardiocentesis]] must be promptly performed. Pericardial drainage combined with effective systemic antibiotic therapy is mandatory (antistaphylococcal agent plus aminoglycoside, followed by tailored antibiotic therapy according to cultures). Frequent irrigation of the pericardial cavity with [[urokinase]] or [[streptokinase]] may be considered. Open surgical drainage through subxiphoid pericardiotomy is preferable. [[Pericardiectomy]] may be required in patients with dense adhesions, loculated and thick purulent effusion, recurrence of tamponade, persistent infection, and progression to constriction. | |||
* Viral pericarditis | * Viral pericarditis | ||
:* '''CMV pericarditis''' | :* '''CMV pericarditis''' | ||
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::* Preferred regimen: [[Immunoglobulin]] 10 g intravenously at day 1 and 3 for 6–8 hours | ::* Preferred regimen: [[Immunoglobulin]] 10 g intravenously at day 1 and 3 for 6–8 hours | ||
::: Note: Symptomatic treatment is given to the patients with viral [[pericarditis]] while in large effusions and [[cardiac tamponade]] [[pericardiocentesis]] is necessary. The use of [[corticosteroid]] therapy is contraindicated except in patients with secondary [[tuberculous pericarditis]], as an adjunct to [[tuberculosis]] treatment. Drainage, if needed is done. | ::: Note: Symptomatic treatment is given to the patients with viral [[pericarditis]] while in large effusions and [[cardiac tamponade]] [[pericardiocentesis]] is necessary. The use of [[corticosteroid]] therapy is contraindicated except in patients with secondary [[tuberculous pericarditis]], as an adjunct to [[tuberculosis]] treatment. Drainage, if needed is done. | ||
* Fungal pericarditis | |||
==References== | |||
{{reflist|2}} | |||
Revision as of 21:51, 28 May 2015
- Purulent pericarditis with contiguous pneumonia
- Preferred regimen: Vancomycin 1 g IV q12h targeting trough levels of 15–20 μg/mL AND (Ceftriaxone 1–2 g IV q12h OR Cefotaxime 2 g IV q6–8h) AND (Ciprofloxacin 400 mg IV q12h OR Levofloxacin 500–750 mg IV q24h)
- Purulent pericarditis with contiguous head and neck infection
- Preferred regimen: Imipenem 500 mg IV q6–8h OR Ampicillin-Sulbactam 3 g IV q6h
- Purulent pericarditis secondary to infective endocarditis
- Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h targeting trough levels of 15–20 μg/mL AND Gentamicin 3 mg/kg/day IV q8–12h
- Note: Pericardiocentesis must be promptly performed. Pericardial drainage combined with effective systemic antibiotic therapy is mandatory (antistaphylococcal agent plus aminoglycoside, followed by tailored antibiotic therapy according to cultures). Frequent irrigation of the pericardial cavity with urokinase or streptokinase may be considered. Open surgical drainage through subxiphoid pericardiotomy is preferable. Pericardiectomy may be required in patients with dense adhesions, loculated and thick purulent effusion, recurrence of tamponade, persistent infection, and progression to constriction.
- Viral pericarditis
- CMV pericarditis
- Preferred regimen: immunoglobulin 1 time per day 4 ml/kg on day 0, 4, and 8; 2 ml/kg on day 12 and 16.
- Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
- Coxsackie B pericarditis
- Preferred regimen: Interferon alpha or beta 2,5 Mio. IU/m2 surface area s.c. 3×per week.
- Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
- Adenovirus and parvovirus B19 perimyocarditis
- Preferred regimen: Immunoglobulin 10 g intravenously at day 1 and 3 for 6–8 hours
- Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
- Fungal pericarditis
References
- ↑ Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y; et al. (2004). "Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology". Eur Heart J. 25 (7): 587–610. doi:10.1016/j.ehj.2004.02.002. PMID 15120056.
- ↑ Pankuweit, Sabine; Ristić, Arsen D.; Seferović, Petar M.; Maisch, Bernhard (2005). "Bacterial pericarditis: diagnosis and management". American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions. 5 (2): 103–112. ISSN 1175-3277. PMID 15725041.
- ↑ Goodman, null (2000-08). "Purulent Pericarditis". Current Treatment Options in Cardiovascular Medicine. 2 (4): 343–350. ISSN 1092-8464. PMID 11096539. Check date values in:
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