[Primary purulent pericarditis due to staphylococcus aureus septicemia]

Purulent pericarditis was rarely primitive and commonly it was the spread from a contiguous focus of infection within the chest. We describe a case of a primitive purulent pericarditis due to Staphylococcus aureus septicaemia. GA, 21 years old men, admitted for chest pain and fever due to a Staphylococcus aureus septicemia. Iterative echocardiography showed a discreet clear circumferential pericardial effusion rapidly growing becoming shady and appearance of a right atrium thrombi. Transoesophageal echocardiography showed no valvular abnormalities and confirm the right atrium thrombi attached to the atrial septum. The septic syndrome persist despite suitable antibiotic therapy and the patient presented a shortness of breath due to a pulmonary embolism over an anticoagulation therapy. Later pericardial effusion become important and impressive. The surgical drainage of a purulent fluid was performed. The further course was favourable and the patient was discharged after 5 weeks without signs of ongoing infection or pericarditis. Nine month later, he was asymptomatic and trans-thoracic echocardiography showed no pericardial effusion or sign of constrictive pericarditis

[Distribution of cardiovascular risk factors in coronary patients in Sahel Tunisia]

We evaluated cardiovascular risk factors and their association in patients in Sahel, hospitalized for coronary disease over the period 1994-1998. The clinical features of 3455 patients [72.4% men, 1741 with myocardial infarction, 1714 with unstable angina] were analysed on hospital admission. The prevalence of smoking, dyslipidaemia, hypertension, diabetes and obesity was 77.4%, 39.4%, 28.5%, 42.5% and 25.1% respectively in men and 2.9%, 43.7%, 59.2%, 56.6% and 31.9% respectively in women. With this risk factor profile a national strategy of primary prevention and heart health promotion is needed in Tunisia