BACKGROUND: During winter, the influenza and Respiratory Syncytial Virus season, children are often seen in the emergency department with fever and respiratory symptoms. CASE DESCRIPTION: We describe the case of a 2-year-old girl with fever, dyspnea and signs of heart failure during physical examination. Echocardiogram showed a large amount of pericardial effusion with signs of cardiac tamponade. Pericardiocentesis showed 200 ml purulent liquid. Surgical drainage was performed. However pericardial effusion recurred. Because constrictive pericarditis was feared, a pericardiectomy was performed after which the patient recovered. Cultures showed Haemophilus influenzae type b and the patient was treated with amoxicillin for 4 weeks in total. CONCLUSION: Fever and dyspnea may also be caused by a problem outside the respiratory system. With physical examination a cardiac cause, such as pericarditis, can be detected. An ECG is easily obtained and can help in the differential diagnosis. An echocardiogram can confirm the diagnosis.
|Journal||Nederlands Tijdschrift voor Geneeskunde|
|Publication status||Published - 21 Oct 2021|