Etiologia i leczenie wysiękowego zapalenia osierdzia u dzieci – doświadczenia własne

Abstract

BackgroundExudative pericarditis may occur in the course of many diseases, but in approximately 30% of patients fail to establish a specific etiology. AimThe aim of this study was to analyze the clinical, etiological factors, assessment and evaluation of treatment efficacy in children with the exudative pericarditis. Material and methods. We analyzed 17 patients, mean age 5 years, hospitalized in the Paediatric Cardiology Department in the period from 2005 to 2011 year. In all children the blood laboratory tests, the study of pericardial fluid, chest X-ray, echocardiogram, and resting ECG were performed. ResultsAll patients suffered from clinical symptoms: fever, respiratory infection, vomiting, shortness of breath, cough, chest pain and abdominal pain. The echocardiography was found in the pericardial fluid, in 12 children around the entire heart, in 2 for the right and in 3 patients with left ventricle. In 12 (70%) patients underwent surgical drainage of the pericardium. In all children a comprehensive study of fluid from the sac were performed, which did not reveal a specific etiology of effusion. On the basis of serological testing of blood in one child diagnosed with Yersinia enterocolitica infection, one patient Candida albicans infection, infection with one stick of Salmonella group B and one patient infected with Cytomegalia virus. All patients used diuretic, antibiotic therapy and nonsteroid antyinflammatory drugs. Conclusion1. Etiological factor of exudative pericarditis was found in only 24% patients. 2. In none of patient study of fluid from the sac did not reveal the etiology of the disease. 3. It has been found highly effective surgical and applied pharmacology treatment of exudative pericarditis, with no recurrence of the pericardial fluid in none of patient.