Q J Med 1966; 35: 293-311
© 1966 Association of Physicians
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AMOEBIC PERICARDITIS
Department of Medicine, University of Natal and the Amoebiasis Research Unit2
Received 10 July 1965 Twenty-five patients with amoebic pericarditis were studied and the clinical findings described. Two types were recognized, one with a serous effusion associated with a left lobe liver abscess and the other with a purulent effusion resulting from rupture of a liver abscess into the pericardium. These have been termed presuppurative and suppurative amoebic pericarditis respectively. The first type may progress to the second.
Five patients suffered from the presuppurative variety of pericarditis and all recovered following treatment of the liver abscess.
Of the 20 patients with suppurative pericarditis 12 recovered and had no residual disability. In the eight patients who succumbed, death was due to cardiac tamponade (usually when the correct diagnosis had not been made) or to constrictive pericarditis in which surgery was unsuccessful.
It appears from this series that if suppurative amoebio pericarditis is treated by pericardial aspiration to relieve tamponade, and by the anti-amoebic drugs emetine hydrochloride and chloroquine, a proportion of patients recover fully without developing constriction. When constrictive pericarditis develops, conservative treatment should be continued as resolution often occurs. Pericardectomy should be reserved for cases in which death seems inevitable unless constriction is relieved.
2 The Amoebiasis Research Unit is sponsored by the following bodies: The South African Council for Scientific and Industrial Research, University of Natal, Natal Pro vincial Administration, United States Public Health Service (Grant E-1592).
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  R. F. Heller, S. L. Gorbach, C. J. Tatooles, H. S. Loeb, and S. H. Rahimtoola Amebic Pericarditis JAMA, May 15, 1972; 220(7): 988 - 990. [Abstract] [PDF]
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