心タンポナーデを呈した高齢男性の心膜タンポナーデを呈した心筋膿瘍．

Pyopericardium presenting with echocardiographic features of pericardial tamponade in an elderly man.

• Jih Huei Tan
• Zi Qin Ng
• Henry Chor Lip Tan
• Simon Vendargon

抄録

72歳の中国人男性が軽度の心不全症状を呈した。臨床的には比較的良好であったが、経胸腔エコー検査では心タンポナーデの徴候が認められた。心嚢穿刺は左前側胸腔切開術で行われたが，心尖部と右心室の周囲に薄い胸水の層が見られるだけで，吸引窓が狭く，心嚢穿刺は行われなかった．術中に500cmの膿性液が排出された。微生物検査はすべて陰性であった。心嚢腫を呈した高齢者の非定型臨床経過を紹介する。

A 72-year-old Chinese man presented with mild symptoms of heart failure. Transthoracic echocardiography showed signs of cardiac tamponade though clinically he was relatively well. The option of pericardiocentesis was not carried out due to a narrow window for aspiration with only a thin layer of effusion seen surrounding the apex and right ventricle on subcostal view.Pericardial window was done via a left anterolateral thoracotomy. Intraoperatively, 500 cm of purulent fluid was drained. Microbiology screens were all negative. We present the atypical clinical course of this elderly man presenting with a large pyopericardium.

© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.