What is bacterial pericarditis?
The pericardium is a thin membrane that surrounds and
protects your heart. This membrane helps prevent infection and also keeps your
heart from expanding too much. Diseases and health problems can cause an
inflammation of this membrane, or pericarditis. The causes of pericarditis
- fungal infections
- parasitic infections
- trauma from surgery or another injury
What are the
symptoms of bacterial pericarditis?
The symptoms of bacterial pericarditis depend on the
severity of your condition and any underlying health problems. The most common
symptom is sharp, stabbing chest pain, also known as pleuritis. This pain often
moves or radiates to other parts of the body, including the left shoulder and
Other symptoms that may occur with bacterial pericarditis
- pain when you breathe
- shortness of breath when lying down
- a fever
- a dry cough
- a general feeling of sickness, or malaise
- splinting of the ribs, causing you to bend over
and hold your chest while breathing
- edema, or swelling in your abdomen or legs
What causes bacterial pericarditis?
This condition occurs when certain bacteria enter the
pericardium and cause infection. The most common bacteria to cause pericarditis
are Staphylococcus, Streptococcus, and Pneumococcus.
Bacteria can enter the pericardium:
- through your bloodstream from another infection
in the body, such as pneumonia
- from an infection in another part of the heart
- through surgery
- when a catheter is inserted to drain fluid from
- as a result of trauma
People with a weak immune system are at an increased risk of
developing bacterial pericarditis because their bodies are less able to fight
infection. Health problems that may increase your risk of developing this
- immune deficiency conditions such as HIV or AIDS
- chronic diseases, such as diabetes
- alcohol abuse
- vascular heart disease
- uremia, or excess uric acid in your blood
According to the Cleveland Clinic,
men between 20 and 50 are more likely to develop this condition. Bacterial
pericarditis often develops following a lung infection.
How is bacterial pericarditis diagnosed?
Your doctor will perform a physical exam to see if you have the
symptoms of bacterial pericarditis. They’ll use a stethoscope to listen for
sounds in your chest. If you have bacterial pericarditis, they’ll be able to
detect pericardial rub, which is a sound that occurs when the layers of the
infected pericardium rub together.
Your doctor may also check to see if
- sepsis, which is a severe and potentially
life-threatening infection that can spread throughout your body
- pericardial effusion, or fluid buildup in your
- pleural effusion, or fluid buildup in the area
around your lungs
If you have any of these conditions, your doctor will order
additional tests to confirm a diagnosis. These tests may include:
- a CT scan of your chest
- an MRI of your chest
- an X-ray of your chest, specifically of the
lungs, heart, large arteries, ribs, and diaphragm
- an echocardiogram, which is a test that uses
sound waves to create a moving image of your heart
- an electrocardiogram to measure the electrical
impulses your heart gives off
If you have pericarditis, your doctor will need to determine
if bacteria have caused it. Your doctor may need to order tests to detect the
presence of harmful bacteria. These tests include:
- blood cultures
- a complete blood count
- a culture of the pericardial fluid
- a gram stain of the pericardial fluid
How is bacterial pericarditis treated?
The goal of treatment is to cure the infection. Bed rest is
important, and you’ll also need to elevate your head while lying down to reduce
the strain on your heart.
Your doctor may also prescribe medications, including:
- antibiotics to treat the infection
- over-the-counter or narcotic pain relievers
- corticosteroids to reduce inflammation of the
- diuretics to reduce fluid volume in your body
If your condition is severe, you may need surgery,
- a subxiphoid pericardiotomy, which involves
making a hole in your pericardium to allow fluid to drain out
- a pericardiocentesis, which involves inserting a
catheter to drain fluid from your pericardium
- a surgical pericardiectomy, which involves
removing part of your pericardial sac
Some people develop a condition known as chronic
pericarditis, in which infection lasts for six months or more, or frequently
recurs. Doctors only remove the pericardium if other treatments can’t stop the infection
from occurring again.
What are the complications associated with bacterial pericarditis?
Complications from this condition can include:
- cardiac tamponade, which is compression of the
heart caused by the buildup of fluid in the space around your heart muscle
- constrictive heart failure, which occurs when
your heart can’t pump enough blood to the rest of your body
- pulmonary edema, which is an abnormal fluid
buildup in the sacs of your lungs
If you develop any of these complications, it may be more
difficult to treat your pericarditis and it may lead to chronic pericarditis.
What is the outlook for people with bacterial pericarditis?
Your outlook depends on whether you develop any other health
complications. Other complications will need treatment. This prolongs the period
of illness and increases the risk of permanent damage and recurrence of
Early detection and diagnosis are important to stop and
treat bacterial pericarditis before it spreads and creates other complications.
If you get the proper treatment, it can last up to three months, and you can
recover completely and return to normal activities once the infection goes
away. If you don’t get treatment, it can lead to other health issues and it can