infectious-diseases-2016_posters-accepted-abstracts

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Volume 4, Issue 4(Suppl) J Infect Dis Ther 2016
ISSN: 2332-0877, JIDT an open access journal
Page 84
Notes:
Infectious Diseases 2016
August 24-26, 2016
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August 24-26, 2016 Philadelphia, USA
&
Infectious DiseasesJoint Event on 2nd World Congress on
Pediatric Care & Pediatric Infectious Diseases
International Conference on
Recurrent cardiac tamponade secondary to coxsackie B type 4
Moamen AL Zoubi1, Sujata Situla2 and Carmen Jan Liao3
1,2,3Advocate Illinois Masonic Medical Center, USA
C ardiac tamponade is a life threatening condition often requiring urgent or emergent pericardiocentesis and close monitoring in
the ICU. We report a 51 year-old spanish speaking female with a history of hypothyroidism who presented with facial swelling
, SOB and orthopnea for 3 weeks. She denies joint pain, rash, fever, chills, weight loss. She had travelled to Mexico 6 years ago but
did not remember exposure to TB patients. She had not received BCG vaccine as a child. In the ER her vitals were stable. Labs
were remarkable for Alk phos 230, AST 63 and ALT 102. Otherwise, unremarkable including normal thyroid function test. ANA
comprehensive panel and HIV test were negative. The ECG showed sinus rhythm and low QRS amplitude. Chest X-ray demonstrated
bilateral pleural effusion. Echocardiogram showed large pericardial effusion with features consistent with tamponade physiology.
Urgent pericardiocentesis was done with 450 ml fluid withdrawn. Thoracentesis was done as well and samples were sent for
analysis. The fluids was an exudate. AFB smears and fungal culture came back negative. Repeated Echo showed complete resolution
of pericardial effusion. Patient was discharged on colchicine 0.6 mg by mouth twice a day x2 weeks. Two weeks later the patient
presented again with dyspnea and found to have cardiac tamponade after performing Echocardiography. Patient was taken to the
operating room and a pericardial window was performed. TB quantiferon test found to be positive from the previous admission and
she was started empirically on anti-TB medication as recommended by infectious diseases service. The results of pericardial biopsy
showed no evidence of TB or sarcoidosis. No granulomas or malignant cells were seen. AFB smear was negative in three consecutive
samples and Anti-TB medication were discontinued. Viral serology sent and came back elevated as high as 320:1 for coxsackie B type
4. Repeated Echocardiogram showed no pericardial effusion and patient reported improvement of her symptoms. The patient was
discharged on indomethacin 50 mg BID with a cardiology follow up in 2 weeks. To the best of our knowledge, this is the first reported
case of cardiac tamponade secondary to group B coxsackieviruses. We encourage considering viral causes as a probable etiology for
cardiac tamponade of unknown etiology.
Biography
Moamen AL Zoubi is affiliated to Advocate Illinois Masonic Medical Center, USA
Moamen AL Zoubi et al., J Infect Dis Ther 2016, 4:4(Suppl)