Pericarditi

Definition of the syndrome
Acute pericarditis is a syndrome caused by the inflammation of
the pericardium, a sac composed of visceral and parietal layers
separated by the pericardial cavity. Acute pericarditis can be
dry, fibrinous or effusive, independent from its etiology, and may
occur as an isolated entity or as a result of a systemic disease
Detection and treatment of pericarditis remains a challenging
problem and the aetiology is unknown in 40 to 85% of the
cases. We have previously developed [1] a diagnostic strategy
that recommends the systematic use of a combination of non
invasive tests for the diagnosis of benign pericardial effusions.
In addition, it allowed identifying two frequently under
diagnosed causes in our area, Q fever [2,3] and
hypothyroidism, both of which are easily treated. This strategy
lead to a reduction in the number of pericarditis classified as
idiopathic compared to a prescription based on selecting
laboratory tests intuitively [4,5].
For some patients pericardiocentesis is necessary. We perform
a systematic analysis of pericardial fluid and biopsy specimens,
using cultures and molecular analyses for identification of
bacteriological, fungal, and viral agents, as well as
histopathological examination [6].
1/ Levy PY, Corey R, Berger P, et al. Etiologic diagnosis of 204
pericardial effusions. Medicine (Baltimore) 2003; 82: 385-91.
2/ Levy PY, Raoult D. Coxiella burnetii pericarditis : a report of
15 cases and review. Clin Infect Dis. 1999;29:393-397.