{"id":3187,"date":"2017-07-14T14:45:03","date_gmt":"2017-07-14T14:45:03","guid":{"rendered":"https:\/\/inmedblogs.us\/nicholascomninellis\/?p=3187"},"modified":"2017-07-14T16:13:15","modified_gmt":"2017-07-14T16:13:15","slug":"pyopericarditis-angola-day-14","status":"publish","type":"post","link":"https:\/\/inmedblogs.us\/nicholascomninellis\/2017\/07\/14\/pyopericarditis-angola-day-14\/","title":{"rendered":"Pyopericarditis &#8211; Angola Day 14"},"content":{"rendered":"<p><a href=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/echo-e1500043481417.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\"alignleft size-full wp-image-3189\" src=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/echo-e1500043481417.jpg\" alt=\"\" width=\"530\" height=\"379\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>Caution: This is a graphic description. In my post on July 2, <a href=\"https:\/\/inmedblogs.us\/nicholascomninellis\/2017\/07\/02\/aberrant-abscesses-angola-day-2\/\">Aberrant Abscesses &#8211; Angola Day 2<\/a>, I described the plight of a seven-year old boy with pockets of pus erupting in his leg, shoulder and hip. Let&#8217;s call him &#8220;Lobito.&#8221; After drainage of the hip abscess on that date Lobito&#8217;s fever and appetite gradually improved. But this progress was unfortunately short lived. Over the weekend Lobito became short of breath and his chest X-ray revealed a new finding: an abnormally round heart size. Yesterday, ultrasound of his heart demonstrated the presence of thick pericardial fluid, represented by the blue line that measures 2 cm in depth where there should be no visible fluid at all.<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/pus-1.jpg\"><img decoding=\"async\" class=\"alignleft size-full wp-image-3201\" src=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/pus-1.jpg\" alt=\"\" width=\"530\" height=\"701\" srcset=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/pus-1.jpg 530w, https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/pus-1-227x300.jpg 227w\" sizes=\"(max-width: 530px) 100vw, 530px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>Yesterday our esteemed surgeon, Annelise Olson, performed a pericardiocentesis &#8211; insertion of a needle into the pericardium. Immediately, yellow-green colored pus erupted from the puncture. A large bore catheter we inserted where the needed has been, and in the image above I&#8217;m aspirating 300 ml of pus, accumulating in this blue bowl. Almost immediately Lobito&#8217;s oxygen requirement predictably decreased as heart, which had been compressed by the pus, began beating freely.<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/lobito.jpg\"><img decoding=\"async\" class=\"alignleft size-full wp-image-3199\" src=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/lobito.jpg\" alt=\"\" width=\"530\" height=\"364\" srcset=\"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/lobito.jpg 530w, https:\/\/inmedblogs.us\/nicholascomninellis\/wp-content\/uploads\/sites\/2\/2017\/07\/lobito-300x206.jpg 300w\" sizes=\"(max-width: 530px) 100vw, 530px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>But pyopericarditis is both a rare and a lethal infection. Individuals often die from the overwhelming sepsis and cardiac failure that accompanies the disease. This morning I approached Lobito&#8217;s bedside with trepidation. What did I discover? Please judge for yourself from the photo above.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Caution: This is a graphic description. In my post on July 2, Aberrant Abscesses &#8211; Angola Day 2, I described the plight of a seven-year old boy with pockets of pus erupting in his leg, shoulder and hip. Let&#8217;s call him &#8220;Lobito.&#8221; After drainage of the hip abscess on that date Lobito&#8217;s fever and [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[46],"tags":[],"class_list":["post-3187","post","type-post","status-publish","format-standard","hentry","category-2017-angola"],"_links":{"self":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts\/3187","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/comments?post=3187"}],"version-history":[{"count":0,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/posts\/3187\/revisions"}],"wp:attachment":[{"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/media?parent=3187"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/categories?post=3187"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/inmedblogs.us\/nicholascomninellis\/wp-json\/wp\/v2\/tags?post=3187"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}