Pericarditis aguda y taponamiento cardiaco por Haemophilus influenzae tipo IVb en una paciente pediátrica. Comunicación de un caso de autopsia, El Salvador

Abstract

This article presents the case of a female preschool age 4, who in March 2006 was referred urgently to the National Children Hospital Benjamín Bloom (HNNBB) in San Salvador, El Salvador, with a history of fever, headache, cough, breathlessness and severe chest pain. The study of chest X-ray showed a grade IV cardiomegaly, and minutes after admission to the intensive care unit, patient died with clinical diagnosis of sepsis, dilated cardiomyopathy and heart failure. The patient underwent autopsy study in the Department of Pathology of the Hospital, where there was an acute pericarditis abscess with no affection of other organs, but that was enough to cause a cardiac tamponade and death of the patient. Culture revealed the bacteria Haemophylus influenzae type IVb as causing the situation described, and it was confirmed by immunohistochemistry and PCR (tests conducted at the CDC in Atlanta in autopsy tissue sent for this purpose). The importance of this case lies in the atypical nature of the clinical presentation. Pericardial injuries are frequently expected to be associated to other diseases or disorders of the heart secondary to adjacent structures, or as a complication of systemic disease. The isolated pericardial disease itself is unusual and also evidences the problems facing primary care before a disease that can be prevented through vaccination, highlighting the failure of preventive medicine. Case is described and discussed and literature is reviewed