Etiological and Evolutionary Profile of the Child’s Pericarditis in Tropical Environments

Pericarditis is an inflammation of the lining surrounding the heart (the pericardial sac). Pericardial effusion is a collection of fluid in the pericardial sac. This fluid may be produced by inflammation. The cause of pericarditis in most individuals is unknown but is likely due to viral infection. This study was to describe the etiological and evolutionary aspects of fluid pericarditis in pediatric cardiology at Institute of Cardiology of Abidjan (ICA). 

The authors conducted a retrospective study of 42 cases of fluid pericarditis diagnosed among 202 children hospitalized over a five-year period (1^st January 2009 to 31^st December 2014). All patients with pericardial effusion were included in the study. The prevalence was estimated at 20.8% of hospitalizations, sex ratio was 1.1 with a female predominance (52%) and the mean age at 9.2 years old (11 days old to 15 years old).

The results indicated that dyspnea (64%), cardiomegaly (24%), fever (10%) and chest pain (48%) were dominated by the discovery. The most frequently seen radiological abnormality was cardiomegaly (100%). The mean of the cardiothoracic index (I.C.T) was 0.71 with extremes ranging from 0.59 to 0.87. The etiological investigation made it possible to link fluid pericarditis to a cause in all the patients and the etiologic varieties identified were: tuberculosis 22 cases, 52%, rheumatic pericarditis 6 cases (14.3%), chronic parietal endocarditis 5 cases (11.9%), bacterial pericarditis with trivial germ 3 cases (7.1% 3 cases (7.1%), post-surgery syndrome 2 cases (4.8%), umbilical post-catheterization 1 case (2.4%). HIV serology was positive in 11.9% of cases. The progression was favorable in 55% of the cases with 10% of deaths. 

In conclusion, fluid pericarditis in children is a severe condition that is clearly on the rise today, especially in immunocompromised patients. Optimal management of fluid pericarditis in children is the best guarantee to avoid short-term tamponade and in the medium term constriction.

Article by Richard Azagoh-Kouadi, et al, from Côte d’Ivoire.

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Image by Anna Luiza Aragão, from Flickr-cc.