TULAREMIC PERICARDITIS: A REPORT OF TWO CASES INCLUDING ONE OF CONSTRICTIVE PERICARDITIS

Abstract

A 13-yr.-old boy developed pleuropul-monary manifestations followed by acute tularemic pericarditis with effusion. Gradually, signs of constrictive pericarditis developed in spite of streptomycin, which was started during the fourth month. Pericardectomy was required to relieve his distress. Results were excellent as judged by follow up observations. A 33-yr.-old man developed tularemic pneumonia after skinning an infected rabbit. Pneumonia was followed by percarditis with effusion and symptoms of cardiac embarrassment persisting for more than a yr. However, the symptoms subsided spontaneously and only ecg. changes remained after a 7-yr. follow up. Reviewing 12 previously reported cases, it was concluded this rare complication develops only in cases exhibiting pleuropulmonary manifestations. Tularemia should be added to the list of diseases causing constrictive pericarditis.