Capnocytophaga Induced Acute Necrotizing and Exudative Pericarditis with Abscess Formation

Abstract

We present the case of a 55-year-old gentleman, with bilateral pulmonary embolism and a large pericardial effusion that lead to a pericardial window with evacuation of creamy pus. Gram stains were negative, with culture growing Capnocytophaga. Pathology revealed acute necrotizing and exudative changes, including frank abscess formation. In developed countries, pericardial abscess and acute pericarditis are uncommon due to availability of broad-spectrum antibiotics. Pericardial abscess due to Capnocytophaga is even more uncommon.

Figure 1

Computed tomography (CT) scan of the chest with intravenous contrast, which reveals a very large pericardial effusion, compressing the right and left ventricles and the right atrium.

Figure 2

2D echocardiogram image of cardiac tamponade with right ventricular diastolic collapse and a large fibrinous exudative pericardial effusion.

Figure 3

Low power and high power of pericardial tissue showing acute necrotizing and exudative changes and frank abscess formation. (a) Low-power view. (b) High-power view.