Objective.The study was undertaken to determine the etiology, reviewmanagement, and outcome in children diagnosed with acute\npericarditis during 11 years at tertiary pediatric institution. Methods. Retrospective chart review of children diagnosed between\n2004 and 2014. Patients with postsurgical pericardial effusions were excluded. Results.Thirty-two children were identified (median\nage 10yr/11mo). Pericardiocentesis was performed in 24/32 (75%) patients.The most common cause of pericarditis was infection\nin 11/32 (34%), followed by inflammatory disorders in 9 (28%). Purulent pericarditis occurred in 5 children including 4 due to\nStaphylococcus aureus: 2 were methicillin resistant (MRSA). All patients with purulent pericarditis had concomitant infection\nincluding soft tissue, bone, or lung infection; all had pericardial drain placement and 2 required pericardiotomy and mediastinal\nexploration.Other infectionswere due toHistoplasma capsulatum (2),Mycoplasma pneumoniae (2), InfluenzaA(1), and Enterovirus\n(1). Pericarditis/pericardial effusion was the initial presentation in 4 children with systemic lupus erythematosus including one who\npresentedwith tamponade and in 2 children who were diagnosed with systemic onset juvenile inflammatory arthritis. Tumorswere\ndiagnosed in 2 patients. Five children had recurrent pericarditis. Systemic antibiotics were used in 21/32 (66%) and prednisone was\nused in 11/32 (34%) patients. Conclusion. Infections remain an important cause of pericarditis in children. Purulent pericarditis\nis most commonly caused by Staphylococcus aureus and is associated with significant morbidity, need of surgical intervention,\nand prolonged antibiotic therapy. Echocardiography-guided thoracocentesis remains the preferred diagnostic and therapeutic\napproach.However, pericardiotomy and drainage are needed when appropriate clinical response is not achievedwith percutaneous\ndrainage.
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