SHM Converge Scientific Abstract ePoster Gallery-Serratia Marcescens-Induced Pericarditis Leading to Rapid-Onset Cardiac Tamponade in a Patient With Underlying Malignancy

Pdf Summary

This case report describes a rare instance of <strong>Serratia marcescens pericarditis</strong> causing <strong>rapidly progressive pericardial effusion and impending cardiac tamponade</strong> in a 66-year-old man with a history of <strong>intravenous drug use</strong> and newly diagnosed <strong>small cell lung cancer</strong>.

The patient presented with <strong>1 day of substernal chest pain and dyspnea</strong>. Initial ECG showed diffuse nonspecific ST elevations. Imaging initially showed only a trivial pericardial effusion, but within 2 days this progressed to a moderate effusion. Echocardiography demonstrated features concerning for <strong>cardiac tamponade</strong>, though there were no vegetations to suggest endocarditis. A pericardial window was performed, removing <strong>300 mL of fluid</strong>. Culture of the pericardial fluid grew <strong>Serratia marcescens</strong>. Pericardial biopsy and fluid cytology showed <strong>no malignancy</strong>.

The patient also had a complex infectious and oncologic background, including a urine culture positive for <strong>Klebsiella pneumoniae</strong>, bronchoscopy showing <strong>small cell lung cancer</strong>, and lung culture growing <strong>Actinomyces</strong>. Despite the presence of lung malignancy, the pericardial findings were not due to malignant involvement.

The authors emphasize that <strong>bacterial pericarditis is uncommon</strong>, and Serratia-related pericarditis is especially rare, with only one prior case identified in the literature. This case is notable because the infection caused tamponade <strong>without bacteremia or endocarditis</strong>. The report highlights the importance of considering an <strong>infectious cause</strong> when pericardial effusion accumulates rapidly, especially in patients with risk factors such as <strong>IV drug use</strong>. Early recognition, drainage, culture of pericardial fluid, and prompt antibiotic treatment are essential to prevent life-threatening complications.

Asset Subtitle

Ashirbad Acharya

Meta Tag

Author List Ashirbad Acharya, Ranjit Sapkota, Ricardo Conti, Shanti Sharma, Shristi Nepal

Category Clinical Vignettes

Concept Serratia marcescens

Concept Infectious Pericarditis

Concept Cardiac Tamponade

Concept Healthcare-Associated Infection

Concept Pericardial Effusion

Distinguished Non-Finalist

Presenter Organization AdventHealth Orlando

Presenting Author Ashirbad Acharya

Track Adult

Keywords

Serratia marcescens

pericarditis

pericardial effusion

cardiac tamponade

intravenous drug use

small cell lung cancer

bacterial infection

pericardial window

pericardial fluid culture

rapidly progressive effusion

Serratia marcescens

Infectious Pericarditis

Cardiac Tamponade

Healthcare-Associated Infection

Pericardial Effusion