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The pericardium is a thin, double layered, protective sac that covers the heart. It helps protect the heart from infection and prevents it from expanding too much when the volume of blood increases, thus ensuring that the heart functions efficiently.

Pericarditis is a condition that is caused by an inflammation of the pericardium. It is usually acute and can last for periods up to several months. The inflammation of the membrane appears red and inflamed, similar to the skin around a cut. At times, pericarditis results in a fluid buildup between the layers of the pericardium, a condition known as pericardial effusion.

There are many different causes of pericarditis and bacterial infection of the pericardium is just one of them. Bacterial pericarditis causes an inflammation in the pericarditis. The condition can cause quite a bit of pain, caused when the inflamed layers of the pericardium rub against the heart. Pericardial effusion may also develop as a result of bacterial pericarditis.

Causes

Bacterial pericarditis is commonly caused by the following bacteria:

• Haemophilus influenza (also known as H. flu)
• Meningococci
• Pneumococci
• Staphylococci
• Streptococci

While the incidence of bacterial pericarditis has been on the wane since the advent of antibiotics, care needs to be taken as it can lead to serious complications, including death.

Bacterial pericarditis usually affects males in the age range of twenty and fifty, and usually occurs after a respiratory infection. A skin or a mouth infection that causes bacteremia, may give rise to bacterial pericarditis.

Several cases of bacterial pericarditis have also been reported after heart surgery.

Symptoms

The symptoms of bacterial pericarditis include:

• Chest pain
• Pain that radiates from the chest towards the neck, shoulders or the abdomen
• Pain that is exacerbated by breathing
• Standing or sitting up provides some relief from the pain
• Chills
• Breathing difficulties
• Unproductive or dry cough
• Fever
• Fatigue
• Sweats

Diagnosis

In order to confirm a diagnosis of bacterial pericarditis, the doctor will look for certain signs during a physical examination. These include:

• Faint sounds of the heart beating when heard through a stethoscope
• A rubbing sound audible through the stethoscope
• Low blood pressure that could be the result of septic shock, a life-threatening condition
• Signs of a buildup of fluid in the pericardium
• Signs of a buildup of fluid in the space between the lungs, also known as pleural effusion
• Signs of pneumonia

Your doctor may also ask for certain imaging tests including an echocardiogram, chest x-rays, chest MRI scan or chest CT scan. These will help confirm a buildup of fluid in the pericardium. The fluid can be tested for the presence of bacterial infection using the tests mentioned below:

• Blood cultures
• Complete blood count that shows an increased WBC count
• Pericardial fluid culture
• Pericardial fluid gram stain

Treatment

Treatment focuses on curing the infection.

• Antibiotics
• Analgesics such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs)to relieve pain and inflammation
• Antacids to counter gastric irritation caused by NSAIDs
• Diuretics to get rid of any excess fluids
• Subxiphoid pericardiotomy - A tiny hole is made in the pericardium through which the infected fluid can drain out.
• Pericardiocentesis - The fluid from the pericardium is aspirated to prevent a buildup that could lead to cardiac tamponade
• Surgical pericardiectomy - Surgical removal of a part of the pericardium, usually done in chronic or recurrent cases

Bacterial pericarditis can be a life-threatening condition if it left untreated. Prompt treatment usually results in a favorable outcome, with most people recovering completely.

In some cases, complications such as cardiac tamponade, pulmonary edema or constrictive heart failure may result.

Reference

• http://www.nlm.nih.gov/medlineplus/ency/article/000173.htm