European Heart Journal Advance Access originally published online on May 22, 2006
European Heart Journal 2006 27(16):1942-1946; doi:10.1093/eurheartj/ehl025
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Molecular analysis of pericardial fluid: a 7-year experience
1 Unité des Rickettsies, CNRS UMR 6020, IFR48, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
2 Department of Cardio-Thoracic surgery, CHU Timone, Marseille, France
3 Department of Cardiology, CHU Timone, Marseille, France
Received 2 January 2006; revised 28 March 2006; accepted 20 April 2006; online publish-ahead-of-print 22 May 2006.
* Corresponding author. Tel: +33 491 38 55 17; fax: +33 491 83 03 90. E-mail address: raoult{at}univ.mrs.fr
See page 1898 for the editorial comment on this article (doi:10.1093/eurheartj/ehl156)
Aims Aetiological investigations of pericardial effusion are often negative. We evaluate the interest of systematic analysis of fluid in order to diminish the number of pericarditis classified as idiopathic.
Methods and results We performed a systematic analysis of pericardial fluid and biopsy specimens, using cultures and molecular analyses for the identification of bacteriological, fungal, and viral agents, as well as histopathological examination of 106 pericardial fluid samples. The aetiological diagnosis was determined clinically and by non-invasive procedures in 40 and nine patients, respectively. In the remaining 57 patients, 14 neoplasias and 17 infections were diagnosed. Molecular procedures identified seven viral (Enterovirus, Herpes simplex virus, and Epstein–Barr virus in four, two, and one of the cases, respectively), one fungal (Cryptococcus neoformans), and nine bacterial infections. Four of these bacteria were not diagnosed by culture because of prior antibiotics treatment (Mycobacterium tuberculosis in two cases, Streptococcus pneumoniae in one case, and Actinomyces neuii in one case). The aetiology remained undetermined in 26 patients.
Conclusion The systematic use of molecular techniques permitted a significant increase in aetiological diagnoses of punctured pericardial effusions when compared with cultures (39.5 vs. 13.9%, respectively; P<0.01). It is particularly beneficial for patients with a previous antibiotic regimen or suspicion of tuberculosis.
Key Words: Pericarditis • Cardiac tamponade • Molecular biology
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in EHJ:
- Aetiologic diagnosis of pericardial disease: worthy efforts may not be applied in the appropriate direction
- Jordi Soler-Soler, Jaume Sagristà-Sauleda, and Gaietà Permanyer-Miralda
EHJ 2006 27: 1898-1899.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  R. R. Watkins, K. Anthony, S. Schroder, and G. S. Hall Ventriculoperitoneal Shunt Infection Caused by Actinomyces neuii subsp. neuii J. Clin. Microbiol., May 1, 2008; 46(5): 1888 - 1889. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Soler-Soler, J. Sagrista-Sauleda, and G. Permanyer-Miralda Aetiologic diagnosis of pericardial disease: worthy efforts may not be applied in the appropriate direction Eur. Heart J., August 2, 2006; 27(16): 1898 - 1899. [Full Text] [PDF]
|
|