ArticleJACC. Case reports2026
Purulent Pericarditis After Esophageal Erosion With Streptococcus intermedius and Lactobacillus spp.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Avoiding Diagnostic Anchoring: The Case for Systematic Evaluation of Pericardial Disease.JACC. Case reports · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPurulent pericarditis is rare but rapidly fatal without urgent drainage and targeted antibiotics; malignancy-related effusions should not be presumed malignant when an anatomic breach is possible. CASE PRESENTATION: A 67-year-old male with esophageal squamous cell carcinoma presented with pleuritic chest pain. Electrocardiogram showed diffuse ST elevation; transthoracic echocardiography revealed a large effusion with fibrinous strands and mild right-ventricle diastolic collapse. Computed tomography angiography demonstrated tumor erosion into the left main bronchus. The patient received vancomycin/piperacillin-tazobactam and underwent emergent pericardiocentesis yielding ∼800 mL of cloudy fluid (49,710 cells/μL, glucose 2 mg/dL, lactate dehydrogenase 7,327 U/L; neutrophil predominant; cytology negative; blood cultures returned negative). Cultures grew Streptococcus intermedius and Lactobacillus spp; antibiotics were narrowed to intravenous ceftriaxone for 3 weeks. Persistent tamponade necessitated pericardial window placement on hospital day 4; follow-up echocardiography demonstrated improved effusion with pericardial thickening/calcification. DISCUSSION: In malignancy, diffuse ST elevation and highly inflammatory fluid should prompt evaluation for purulence and an anatomic breach rather than anchoring on malignant effusion. TAKE-HOME MESSAGE: In cancer patients with pericardial effusion, oral/gastrointestinal flora in pericardial cultures should trigger evaluation for an anatomic breach (eg, tumor erosion) and early source control with drainage, culture-directed antibiotics, and surgical escalation when tamponade continues to persist.
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