Acute hemorrhagic pericarditis in a child with pneumonia due to Chlamydophila pneumoniae

Abstract

Chlamydophila pneumoniae is mainly responsible for respiratory tract infections but has also been associated with endocarditis and myocarditis. We report a case of pneumonia in a child with hemorrhagic pericardial effusion with a positive result by a new C. pneumoniae TaqMan PCR, suggesting a pericardial inflammation directly induced by C. pneumoniae. C. pneumoniae should be suspected in patients with community-acquired pneumonia and concurrent pericarditis. Empirical treatment with azithromycin seems feasible.

FIG. 1.

Enlarged cardiac silhouette and bilateral infiltrates seen on the chest X ray.

FIG. 2.

Two-dimensional echocardiogram from an apical four-chamber view shows a large pericardial effusion.

FIG. 3.

Detection of C. pneumoniae by TaqMan PCR. DNAs of samples I and II, each corresponding to 5 μl of the pericardial effusion, were subjected to a C. pneumoniae-specific TaqMan PCR with (gray curves with rhombs) and without (black curves with dots) spiking with 100 copies of the Cpneu plasmid. In parallel, serial dilutions of the Cpneu plasmid were amplified to enable quantification of the PCR; aqua destillata. was used as a negative control. The numbers represent copies per 25-μl PCR mixture.