Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Purulent Pericarditis due to Streptococcus pneumoniae Diagnosed by Pneumococcal Urinary Antigen Assay and 16S rDNA Sequence of the Pericardial Fluid
Chiyo Nakagawa, Kei Kasahara, Shinsuke Yonekawa, Taku Ogawa, Satoshi Kutsuna, Koichi Maeda, Mitsuru Konishi, Ken Kikuchi, Keiichi Mikasa
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Keywords: bacterial pericarditis, pneumococcal urinary antigen test, 16S rDNA sequence, Streptococcus pneumoniae
JOURNAL OPEN ACCESS

2010 Volume 49 Issue 15 Pages 1653-1656

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Abstract

A 57-year old woman was admitted to our hospital with massive pericardial fluid. Culture of the pericardial fluid was negative, however, Binax NOW® Streptococcus pneumoniae urinary antigen test was positive in pericardial fluid. 16S rDNA sequencing and PCR for lyt(A) gene of the pericardial fluid sample confirmed the microbiological diagnosis of S. pneumoniae. The patient was treated with surgical drainage and continuous intravenous infusion of penicillin G and its concentration in the serum and pericardial effusion was monitored. Incorporation of molecular methods such as antigen testing and nucleic acid sequencing would benefit the management of infectious diseases especially in culture negative cases.

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© 2010 by The Japanese Society of Internal Medicine
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