Purulent pericarditis

Excerpt

A 77-year-old Caucasian male was found dead at his residence. He had no significant medical history, except for severe anemia treated with a transfusion two months prior. At autopsy, external examination of the body revealed a well-developed, well-nourished, thin male with no remarkable features. Internal examination of body cavities revealed cloudy yellow fluid within each pleural cavity. The pleural surfaces were focally purulent, particularly inferomedially. The pericardial cavity was completely replaced with thick purulent fluid adherent to both the epicardium and pericardium (Figs. 1, 2, 3, and 4). Further cardiovascular exam revealed cardiomegaly (heart weight 520 g) with focal areas of mild to severe atherosclerosis in the coronary artery system. There was concentric left ventricular hypertrophy, measuring up to 1.7 cm, along with marked biventricular dilatation. The intimal surface of the aorta contained mild to severe complicated atherosclerosis with areas of dilatation along the descending thoracic aorta, as well as the abdominal aorta. The endocardium was unremarkable. On pulmonary examination the upper airway was unobstructed. Sectioning of the lungs disclosed a dark red-blue crepitant, somewhat congested parenchyma with focal areas of increased firmness. Apart from some moderate congestion of the liver parenchyma, all other organ systems were unremarkable.

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