Cardiac tamponade by staphylococcus aureus infection in a case of systemic lupus erythematosus

Abstract

We have experienced a case of systemic lupus erythematosus (SLE) with cardiac tamponade caused by staphylococcus aureus infection. The patient had been treated as SLE for three years at our patient clinic. After the administration of antibiotics for her cervical lymphoadenopathy following dental therapy, ulnar and palmar erythema were aggravated.
Steroid pulse therapy was performed for her exacerbation. Three days after the pulse therapy, low blood pressure, tachycardia, paradoxical pulse and friction rub sound were appeared and echocardiogram demonstrated a large quantity of pericardial effusion, from which staphylococcus aureus was detected.
After the drainage and administration of effective antibiotics for that bacteria, her symptomes were remarkably improved. Pericarditis in SLE is the most common cardiac manifestation. But infectious pericarditis and cardiac tamponade is rare. In this case we suspect the focus of this infection was digital ulcer or cervical lymphonode.