Pericarditis

Diagnostic criteria

• typical chest pain

• pericardial friction rub

• suggestive ECG changes (typically widespread ST-segment elevation, PR depression)
  +/-

• new or worsening pericardial effusion

• increased CRP/ESR (supports diagnosis but neither sensitive nor specific for pericarditis)

Investigations

• cardiac auscultation

• ECG

• transthoracic echocardiogram (TTE)

• ESR/CRP, CBC, creatinine, troponin, CK-MB

• blood cultures

• CXR

• pericardial fluid for C&S, mycobacterial culture, and viral testing

Differential diagnosis

• infectious (viral, bacterial, mycobacterial, fungal, parasitic)

• non-infectious:

  • autoimmune

  • neoplastic

  • metabolic

  • traumatic

  • drug-related

Usually Enterovirus

S. aureus/MRSA
ß-haemolytic Streptococci
S. pneumoniae
Enterobacterales
Ureaplasma spp
Mycoplasma spp
M. tuberculosis

Viral pericarditis

Purulent pericarditis