Pericarditis - bacterial

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Bacterial pericarditis

Heart, front view

Heart, section through the middle

Pericardium

Purulent pericarditis

• Chest pain
  • May move (radiate) to the neck, shoulder, back or abdomen
  • Sharp, stabbing
  • Pain increases with breathing
  • Sitting up or standing relieves pain
• Difficulty breathing
• Splinting of ribs with deep breathing (bends over of holds chest when breathing)
• Dry cough
• Anxiety
• Fatigue
• Fever
• Sweating
• Chills

When listening to the heart through a stethoscope, the health care provider may be able to hear a pericardial rubbing sound. Heart sounds may be faint or sound far away. There may be other signs of fluid in the pericardium (pericardial effusion).

In severe cases, there may be signs of fluid in the space around the lungs (pleural effusion), such as decreased breath sounds. The person may appear very ill and inseptic shock. There may be signs of pneumonia.

Doctors may suspect pericarditis when one of the following tests shows an abnormal amount of fluid in the pericardial sac:

• Chest x-ray
• Echocardiogram
• Chest MRI scan
• Chest CT scan

This condition is diagnosed when the fluid around the pericardial sac is shown to be infected with bacteria. The following tests help doctors make this diagnosis:

• Blood cultures
• Pericardial fluid gram stain
• Pericardial fluid culture
• CBC showing increased WBC count

Review Date: 07/17/2006
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.