Reversible constrictive pericarditis in children: a case report

Reversible constrictive pericarditis in children: a case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Reversible constrictive pericarditis in children: a case report Mingxu Wang, Qirui Li, Yue Yuan, Qiang Sun This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7050032/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Reversible Constrictive pericarditis (CP) is a rare condition characterized by thickening, adhesions, and calcification of the pericardium, causing diastolic restriction, decreased cardiac output, and potential heart failure (Constrictive pericarditis symptoms), though uncommon, exist and can be relieved with drug therapy. Case Presentation: Clinical data from a child with reversible chest CP were retrospectively analyzed. The child presented with rapid onset, persistent fever despite general anti-infective treatment, chest pain, and shortness of breath. Pericardial etiology, specifically methicillin-resistant Staphylococcus aureus, was identified. The condition significantly improved after comprehensive treatment, including anti-infective measures, cardiac care, pericardiocentesis, and drainage, yielding a favorable prognosis. Conclusion: Staphylococcus aureus infection can lead to reversible CP. Early detection and Active treatment are effective, and medical staff should be vigilant for similar cases. methicillin-resistant Staphylococcus aureus children reversible constrictive pericarditis Figures Figure 1 Figure 2 INTRODUCTION Constrictive pericarditis (CP) is a rare condition in which the pericardium is thickened, adhesional, and calcified due to various causes, resulting in diastolic restriction, decreased cardiac output, and even heart failure [1-2] . Approximately 9% of patients with acute pericarditis develop CP; however, a small number can be relieved by drug therapy, which is called reversible CP [3] . Here, we report a case of reversible CP, which can be used to illustrate the course of the disease, diagnosis, and treatment in the context of relevant literature to enhance vigilance and the understanding of the disease among clinicians. CASE PRESENTATION An 8.5-year-old male was admitted to Beijing Children’s Hospital(BCH) for “intermittent fever for 47 days and multiple serous effusions for 35 days”. Apart from fever, there were no obvious accompanying symptoms. The local hospital administered cephalosporins (details unknown) for five days. The patient’s condition did not improve, and the high fever, shortness of breath, and chest pain persisted. The patient’s CRP was > 200 mg/L, and a chest x-ray showed an enlarged cardiac shadow. Electrocardiography showed sinus tachycardia (heart rate 160 beats/min), with the ST segment significantly elevated (Figure 1). Cardiac ultrasound showed a large pericardial effusion, and the ejection fraction was 60%. Ceftriaxone intravenous for 6 days, blood culture indicated methicillin-resistant Staphylococcus aureus, implying sepsis and purulent pericarditis. A 14-day course of intravenous Meropenem was administered, including combined with Vancomycin intravenous for 7 days. However, pericardial effusion culture post-treatment indicated the presence of Staphylococcus aureus, with demonstrated sensitivity to linezolid. The antibiotic regimen was modified to 10-day Linezolid anti-infection treatment, the patient responded well to treatment, exhibiting a normal body temperature, decreased blood inflammatory indicators and a reduction in ascitic and bilateral pleural effusions and pericardial effusion. Unfortunately, because of votim and diarrhea, linezolid switching to Ceftriaxone for 14 days. Then the patient presented with abdominal distention again, accompanied by a progressive increase in ascitic fluid. Ascitic puncture examination indicated negative findings in both exudate analysis and etiological tests, with negative cultures. Three days before admission, the patient had a fever again, accompanied by fatigue, abdominal distension, and edema. The patient was transferred to our hospital for further diagnosis and treatment. Personal and family histories were unremarkable, and exposure to tuberculosis was ruled out. Upon admission, physical examination revealed a body temperature of 36.6°C, pulse 98 times/min, respiration 22 times/min, blood pressure of 98/62 mmHg, weight of 36 kg, and abdominal circumference of 71 cm. The patient was clear, chronically ill, and without skin discoloration or bleeding spots. Mild edema was observed in the face and lower limbs. No jugular venous distension or abnormal pulse was noted. Percussion revealed an enlarged heart boundary with slightly muted heart sounds. The rhythm was regular, and there was no pericardial friction rub. Abdominal distention was evident, with the liver costal margin palpable 6 cm below and the spleen 3 cm under the rib. CRT was less than 2 seconds. Changes in blood inflammatory indexes were noted, and BNP increased (Table 1). Electrolytes, liver and kidney function, blood lipids, and cardiac enzymes were normal. No apparent abnormalities in ASO, virus-related antibodies, mycoplasma antibodies, autoantibodies, coagulation function, or tumor markers were observed. Blood culture results were negative, and Ig and CD series were normal. ECG revealed sinus tachycardia (119 beats per minute) and T-wave inversion. Cardiac ultrasonography showed that the left atrial diameter was slightly enlarged, and a small to moderate low anechoic area could be seen in the filled pericardial cavity. Fine particles could be seen floating in it, approximately 13.6 mm at the widest point (left ventricular side wall), and the echo of the pericardium was thickened, approximately 7.5 mm at the thickest point, and EF was 67%. Cardiac CT showed thickening of the pericardial cavity, with slightly high-density filling and enhancement of the cyst wall. Cardiac MR+ enhancement showed uneven pericardial thickening, multiple pericardial enhancement, measuring approximately 4.5 mm thicker, with annular enhancement around the fluid area, and characteristic ventricular septal jitter signs on the film sequence, together indicating CP due to local pericardial purulent adhesions (Figure 2). Abdominal ultrasound showed that the liver was 5.7 cm below the costal and 4 cm below the xiphoid process. The liver parenchyma was also echoic, with many ascites, approximately 8.7 cm deep. No evidence of hepatomegaly was noted. A diagnosis of sepsis due to methicillin-resistant Staphylococcus aureus infection and CP combined with polyserous effusions (pericardial effusions, pleural effusions, ascites) was made. After admission, the patient was given bed rest and nasal cannula oxygen. CRP remained slightly elevated. Linezolid combined with ceftriaxone was administered as an anti-infection treatment, and oral prednisone acetate (2 mg/kg) was used to reduce pericardial effusion. Sinus tachycardia, polyserous effusion, and elevated BNP were noted. Cardiac insufficiency was considered, digoxin was given for oral cardiac strengthening, furosemide and spironolactone oral diuresis were given to reduce cardiac preload, and Betalux oral administration was given to improve cardiac diastolic function. After 10 days, the patient’s body weight decreased by 5 kg, abdominal circumference decreased to 61 cm, the circadian rhythm was pronounced, and the heart rate decreased (55-110 beats/min) compared to the previous evaluation. Blood inflammatory indexes normalized, the polyserous effusion was significantly absorbed, and the patient’s symptoms disappeared. The patient was discharged with a prescription for oral hormone therapy, which was continued outside the hospital and regularly reduced. At three months follow-up, no ascites effusion was found on abdominal ultrasound, the liver retracted to normal, a chest x-ray showed increased lung markings, no pleural effusion, cardiac color ultrasound showed left atrium fullness, pericardial thickening, and no pericardial effusion. Digoxin was ceased, and oral Betalux and furosemide were continued. After six months of follow-up, the child was in good condition, with normal intra-atrioventricular diameter, slightly thicker pericardium, no signs of constriction of the pericardium, and no pericardial decortication, EF 72%. Followed up for 1 year, Other drug withdrawal, compared with before Cardiac CT: pericardium thickened significantly decreasing, and pericardium was slightly thicker and less uniform. The child was regularly followed up in the cardiac outpatient clinic for three years. ECG and cardiac ultrasound were normal.Unfortunately, due to the contrast medium, the child hasn't examined again for CMR. Table 1: Inflammatory indexes and culture results of venous blood in children Date WBC NE CRP PCT Culture Result （10^9/L） （%） （mg/L） （ng/mL） 4d 18.6 94.9 ＞200 10.59 PB MRSA 1w 15.1 79 64 - PE MRSA 2w 9.3 67.8 134.4 0.17 PB N 3w 5.8 67.1 30.6 ＜0.05 - - 4w 9.6 61.7 47 - ascites N 5w 5.7 56.7 18 - - - 6w 5.3 64.3 13 - PB N 7w 9.6 55.8 ＜0.5 - - - DISCUSSION Staphylococcus aureus is the primary causative organism of purulent pericarditis [ 4 – 5 ] . Thanks to rapid diagnoses and effective treatment, the incidence of pericarditis caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in healthy children is rare; however, clinical vigilance is needed due to the high mortality rate [ 6 ] . In 1987, Sagrista et al. first described the characteristics and clinical manifestations of drug-responsive early CP and named it “reversible CP” [ 7 ] . The clinical manifestations of Staphylococcus aureus-induced purulent pericarditis lack specificity and mostly include high fever, fatigue, chest pain, palpitations, and dyspnea. In the acute inflammatory response period, the pericardium begins to show serous and fibrinous effusion, and early drainage and anti-infection treatment are given. However, some patients may present with fibrin deposition, pericardial adhesion, and mild fibrosis in the pericardium, resulting in limited diastolic function, systemic congestion, low cardiac output, and other CP manifestations. ECG changes associated with pericarditis often depend on the effect of the damaged pericardium on the underlying myocardium. They may include QRS complexes, ST-segments, or T waves, often manifested as ST-segment elevation in the early stages and gradually evolving into T-wave inversion [ 7 – 8 ] . After CP, cardiovascular magnetic resonance (CMR), a non-invasive imaging modality for imaging pericardial disease, often shows mild pericardial thickening, T1WI is hypointense with irregular borders, T2WI shows resolution of pericardial edema, LGE is unenhanced or only locally enhanced, and ventricular septal jitter signs may be evident on movie sequences [ 9 – 10 ] . CMR imaging, in this case, showed multiple enhancements of the pericardium, accompanied by ring-shaped enhancement around the fluid area and characteristic ventricular septal jitter signs on the film sequence, which supported the diagnosis of CP. It has been reported that after MRSA-induced purulent pericarditis progressed to CP in pediatric patients, the condition was relieved by aggressive drainage of pericardial effusion and intravenous infusion of sensitive antibiotics [ 3 ] . The best empirical antibiotic treatment for acute purulent pericarditis in children has not been clearly defined. The resistance rate of CA-MRSA to vancomycin and linezolid is 0 in both domestic and foreign literature, and vancomycin and linezolid are commonly used in domestic literature to report that the drugs sensitive to MRSA susceptibility test results are vancomycin and linezolid; which are the most commonly used antibiotics for the treatment of MRSA pericarditis abroad, so vancomycin or linezolid intravenous infusion is recommended for anti-infection, and the duration of antibiotics varies from 2 to 6 weeks [ 11 – 14 ] . CONCLUSION In conclusion, this case underscores the rapid progression of a condition characterized by acute purulent and CP during MRSA infection. The patient exhibited significant improvement following a comprehensive treatment approach involving pericardial drainage, antibiotic anti-infection therapy, cardiac tonics, diuretics, vasodilators, and combined hormone therapy. Pediatric healthcare practitioners should be alert to these clinical manifestations, emphasizing early and active intervention, prudent surgical considerations, vigilant follow-up, and a multifaceted treatment strategy to optimize prognosis. Declarations 1.Ethics approval and consent to participate: This study was conducted in line with the principles of the Declaration or Helsinki. We have obtained informed consent to participate from the parents or legal guardians of participant. 2.Consent for publication: The parents of this patient consented to the publication of the case and any accompanying images with written informed consent. 3.Clinical trial number: Not applicable. 4.Competing interests: All authors declare no conflict of interest. 5.Funding : This study was supported by Beijing Municipal Hospital Research and Cultivation Program (PX2024044), China. 6.Author’s contributions: Mingxu Wang: Data collection and write article Qirui Li: Data organization and article polishing Qiang Sun: Revise the article and provide fund support Yue Yuan: Revise the article 7.Acknowledgements: Thank you to every teacher who has ever helped me. I am grateful to Professor Qiang Sun for urging me to write and submit articles and providing financial support. I am also grateful to Professor Qirui Li for helping me polish my articles. And I am grateful to myself for having the courage to try again after failure. References ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS).European Heart Journal 2015 Nov 07;36(42). Bhattad PB, Jain V.Constrictive Pericarditis:A Commonly Missed Cause of Treatable Diastolic Heart Failure.[J].Cureus.2020 May 8;12(5):e8024. Niraj K. Yadav, Momin S. Siddique. Constrictive Pericarditis.[J].Siddique StatPearls 2020 01. Bansal N, Walters HL 3rd , Kobayashi D.Purulent Pericarditis Due to Paronychia in a 16-Month-Old Child: A Nail-Biting Story.[J].World Journal for Pediatric and Congenital Heart Surgery,2020.Vol.11(4):NP125-NP128. Abdel-Haq N, Moussa Z, Farhat MH, Chandrasekar L, Asmar BI.Infectious and Noninfectious Acute Pericarditis in Children: An 11-Year Experience.[J].International Journal of Pediatrics,2018,2018:5450697. Sanchez J, Schneider A, Tretter JT, Shopsin B, Al-Qaqaa Y, Khaitan A, Chadha T.Community-Acquired MRSA Pericarditis and Mediastinitis in a Previously Healthy Infant.[J].Journal of Pediatric Intensive Care,2018,7(2). Haley JH, Tajik AJ, Danielson GK, Schaff HV, Mulvagh SL, Oh JK.Transient Constrictive Pericarditis: Causes and Natural History[J]. Journal of the American College of Cardiology. Vol. 43, No. 2, 2004. Tunuguntla H, Jeewa A, Denfield SW.Acute Myocarditis and Pericarditis in Children.[J].Pediatrics In Review,2019,40(1). O'Connor MJ. Imaging the itis: endocarditis, myocarditis, and pericarditis.[J].Current Opinion In Cardiology,2019,34(1). Wang JX, Yang K, Zhao SH. The interpretation of 2020 SCMR position paper on clinical indications for cardiovascular magnetic resonance.[J].Chinese Journal of Magnetic Resonance Imaging, 2021, 12(5). Meena DS, Kumar D, Gopalakrishnan M, Bohra GK, Midha N, Vijayvargiya P, Tiwari S. Purulent pericarditis in a patient with community-acquired methicillin-resistant Staphylococcus aureus: a case report with mini-review[J]. Germs.2020 Sep 1;10(3). Wu X, Wang CQ, He LY, Xu HM, Jing CM, Chen YH, Lin AW, Deng JK, Cao Q, Deng HL, Cai HJ, Chen YP, Yang JH, Zhang T, Huang YY, Hao JH, Yu H. Antimicrobial resistance profile of methicillin-resistant Staphylococcus aureus isolates in children reported from the ISPED surveillance of bacterial resistance, 2016-2021[J]. Front Cell Infect Microbiol,2023 Jan 19;13:1102779. Kong LM, Yang X, Qian SY, Dong F, Liu YC, Wang LJ,Yao KH, Song WQ.Molecular biological characteristics and antimicrobial resistance of Staphylococcus aureus isolated from children with pneumonia.[J]. Chinese Journal of Applied Clinical Pediatrics. 2020,35(4). Gu L, Lai GX, Lin DS, Yu ZY, Ye J, Liu W.Prevalence status and microbiological characteristics of community-associated methicillin-resistant Staphylococcus aureus infection.[J] International Journal of Respiration. 2021,41(3). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7050032","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":488954196,"identity":"fb1523a2-9c0d-4ee8-a134-22485f5c6b89","order_by":0,"name":"Mingxu Wang","email":"","orcid":"","institution":"Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health","correspondingAuthor":false,"prefix":"","firstName":"Mingxu","middleName":"","lastName":"Wang","suffix":""},{"id":488954197,"identity":"10372cd4-a74a-4ec5-aa7f-c5d287a1502e","order_by":1,"name":"Qirui Li","email":"","orcid":"","institution":"Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health","correspondingAuthor":false,"prefix":"","firstName":"Qirui","middleName":"","lastName":"Li","suffix":""},{"id":488954198,"identity":"a41ccb99-d759-49c3-a9a3-a1394d28893a","order_by":2,"name":"Yue Yuan","email":"","orcid":"","institution":"Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health","correspondingAuthor":false,"prefix":"","firstName":"Yue","middleName":"","lastName":"Yuan","suffix":""},{"id":488954199,"identity":"85c0a03c-8127-4649-a247-3a674eab12c7","order_by":3,"name":"Qiang Sun","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAApklEQVRIiWNgGAWjYBACNv7mgw8SKmx4+InWwidxLNngw5k0OckGYrXIMeSoSc5sO2xscIBohzGcYTbmOZOWuPl48gaGHxXbiNDC3HvwMU+FTeK2M88KGHvO3CbGlnPJYFu23cgxYGZsI0pLjpk0b9vhxM0zSNEC8b4E0VpggSwB9MtBovwi3w+LyvbkjQ9+VBChBQkkEB81CC2k6hgFo2AUjIIRAgDpN0BZAtsaeQAAAABJRU5ErkJggg==","orcid":"","institution":"Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health","correspondingAuthor":true,"prefix":"","firstName":"Qiang","middleName":"","lastName":"Sun","suffix":""}],"badges":[],"createdAt":"2025-07-05 02:38:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7050032/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7050032/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87551218,"identity":"16bedf58-62fe-4339-8d42-b2e3b7cbe0f4","added_by":"auto","created_at":"2025-07-25 06:21:45","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":611108,"visible":true,"origin":"","legend":"\u003cp\u003eECG of the child before treatment. Sinus heart rate (160 beats/min), ST segment upward shift.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7050032/v1/833aaf0150518ba52e322aaf.png"},{"id":87551222,"identity":"6b11acac-b0d2-4586-b733-754e30d69201","added_by":"auto","created_at":"2025-07-25 06:21:51","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":267857,"visible":true,"origin":"","legend":"\u003cp\u003eEnhanced CMR: Annular calcified wrap is visible in the pericardial area (red arrow).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7050032/v1/fc4a7f704ae8f55e1bdab9af.png"},{"id":93764008,"identity":"c0f866a7-6b6f-46bd-9d7b-2b928d54e086","added_by":"auto","created_at":"2025-10-17 10:17:10","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1357801,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7050032/v1/ee29bd9c-cbfc-495e-9417-400c10e40a08.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Reversible constrictive pericarditis in children: a case report","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eConstrictive pericarditis (CP) is a rare condition in which the pericardium is thickened, adhesional, and calcified due to various causes, resulting in diastolic restriction, decreased cardiac output, and even heart failure\u003csup\u003e\u0026nbsp;[1-2]\u003c/sup\u003e. Approximately 9% of patients with acute pericarditis develop CP; however, a small number can be relieved by drug therapy, which is called reversible CP \u003csup\u003e[3]\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHere, we report a case of reversible CP, which can be used to illustrate the course of the disease, diagnosis, and treatment in the context of relevant literature to enhance vigilance and the understanding of the disease among clinicians.\u003c/p\u003e"},{"header":"CASE PRESENTATION","content":"\u003cp\u003eAn 8.5-year-old male was admitted to Beijing Children\u0026rsquo;s Hospital(BCH) for \u0026ldquo;intermittent fever for 47 days and multiple serous effusions for 35 days\u0026rdquo;. Apart from fever, there were no obvious accompanying symptoms. The local hospital administered cephalosporins (details unknown) for five days. The patient\u0026rsquo;s condition did not improve, and the high fever, shortness of breath, and chest pain persisted. The patient\u0026rsquo;s CRP was \u0026gt; 200 mg/L, and a chest x-ray showed an enlarged cardiac shadow. Electrocardiography showed sinus tachycardia (heart rate 160 beats/min), with the ST segment significantly elevated (Figure 1). Cardiac ultrasound showed a large pericardial effusion, and the ejection fraction was 60%. Ceftriaxone intravenous for 6 days, blood culture indicated methicillin-resistant Staphylococcus aureus, implying sepsis and purulent pericarditis. A 14-day course of intravenous Meropenem was administered, including combined with Vancomycin intravenous for 7 days. However, pericardial effusion culture post-treatment indicated the presence of Staphylococcus aureus, with demonstrated sensitivity to linezolid. The antibiotic regimen was modified to 10-day Linezolid anti-infection treatment, the patient responded well to treatment, exhibiting a normal body temperature, decreased blood inflammatory indicators and a reduction in ascitic and bilateral pleural effusions and pericardial effusion. Unfortunately, because of votim and diarrhea, linezolid switching to Ceftriaxone for 14 days. Then the patient presented with abdominal distention again, accompanied by a progressive increase in ascitic fluid. Ascitic puncture examination indicated negative findings in both exudate analysis and etiological tests, with negative cultures. Three days before admission, the patient had a fever again, accompanied by fatigue, abdominal distension, and edema. The patient was transferred to our hospital for further diagnosis and treatment. Personal and family histories were unremarkable, and exposure to tuberculosis was ruled out.\u003c/p\u003e\n\u003cp\u003eUpon admission, physical examination revealed a body temperature of 36.6\u0026deg;C, pulse 98 times/min, respiration 22 times/min, blood pressure of 98/62 mmHg, weight of 36 kg, and abdominal circumference of 71 cm. The patient was clear, chronically ill, and without skin discoloration or bleeding spots. Mild edema was observed in the face and lower limbs. No jugular venous distension or abnormal pulse was noted. Percussion revealed an enlarged heart boundary with slightly muted heart sounds. The rhythm was regular, and there was no pericardial friction rub. Abdominal distention was evident, with the liver costal margin palpable 6 cm below and the spleen 3 cm under the rib. CRT was less than 2 seconds.\u003c/p\u003e\n\u003cp\u003eChanges in blood inflammatory indexes were noted, and BNP increased (Table 1). Electrolytes, liver and kidney function, blood lipids, and cardiac enzymes were normal. No apparent abnormalities in ASO, virus-related antibodies, mycoplasma antibodies, autoantibodies, coagulation function, or tumor markers were observed. Blood culture results were negative, and Ig and CD series were normal. ECG revealed sinus tachycardia (119 beats per minute) and T-wave inversion. Cardiac ultrasonography showed that the left atrial diameter was slightly enlarged, and a small to moderate low anechoic area could be seen in the filled pericardial cavity. Fine particles could be seen floating in it, approximately 13.6 mm at the widest point (left ventricular side wall), and the echo of the pericardium was thickened, approximately 7.5 mm at the thickest point, and EF was 67%. Cardiac CT showed thickening of the pericardial cavity, with slightly high-density filling and enhancement of the cyst wall. Cardiac MR+ enhancement showed uneven pericardial thickening, multiple pericardial enhancement, measuring approximately 4.5 mm thicker, with annular enhancement around the fluid area, and characteristic ventricular septal jitter signs on the film sequence, together indicating CP due to local pericardial purulent adhesions (Figure 2). Abdominal ultrasound showed that the liver was 5.7 cm below the costal and 4 cm below the xiphoid process. The liver parenchyma was also echoic, with many ascites, approximately 8.7 cm deep. No evidence of hepatomegaly was noted. A diagnosis of sepsis due to methicillin-resistant Staphylococcus aureus infection and CP combined with polyserous effusions (pericardial effusions, pleural effusions, ascites) was made.\u003c/p\u003e\n\u003cp\u003e After admission, the patient was given bed rest and nasal cannula oxygen. CRP remained slightly elevated. Linezolid combined with ceftriaxone was administered as an anti-infection treatment, and oral prednisone acetate (2 mg/kg) was used to reduce pericardial effusion. Sinus tachycardia, polyserous effusion, and elevated BNP were noted. Cardiac insufficiency was considered, digoxin was given for oral cardiac strengthening, furosemide and spironolactone oral diuresis were given to reduce cardiac preload, and Betalux oral administration was given to improve cardiac diastolic function. After 10 days, the patient\u0026rsquo;s body weight decreased by 5 kg, abdominal circumference decreased to 61 cm, the circadian rhythm was pronounced, and the heart rate decreased (55-110 beats/min) compared to the previous evaluation. Blood inflammatory indexes normalized, the polyserous effusion was significantly absorbed, and the patient\u0026rsquo;s symptoms disappeared. The patient was discharged with a prescription for oral hormone therapy, which was continued outside the hospital and regularly reduced. At three months follow-up, no ascites effusion was found on abdominal ultrasound, the liver retracted to normal, a chest x-ray showed increased lung markings, no pleural effusion, cardiac color ultrasound showed left atrium fullness, pericardial thickening, and no pericardial effusion. Digoxin was ceased, and oral Betalux and furosemide were continued. After six months of follow-up, the child was in good condition, with normal intra-atrioventricular diameter, slightly thicker pericardium, no signs of constriction of the pericardium, and no pericardial decortication, EF 72%. \u0026nbsp; Followed up for 1 year, Other drug withdrawal, compared with before Cardiac CT: pericardium thickened significantly decreasing, and pericardium was slightly thicker and less uniform. The child was regularly followed up in the cardiac outpatient clinic for three years. ECG and cardiac ultrasound were normal.Unfortunately, due to the contrast medium, the child hasn\u0026apos;t examined again for CMR.\u003c/p\u003e\n\u003cp\u003eTable 1: Inflammatory indexes and culture results of venous blood in children\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003eDate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eWBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003eNE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eCRP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003ePCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eCulture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eResult\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e（10^9/L）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e（mg/L）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e（ng/mL）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e4d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e18.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e94.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e＞200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e10.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003ePB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eMRSA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e1w\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e15.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003ePE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eMRSA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e2w\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e67.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e134.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003ePB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e3w\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e67.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e30.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e＜0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e4w\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e61.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eascites\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e5w\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e56.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e6w\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e64.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003ePB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e7w\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e55.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e＜0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eStaphylococcus aureus is the primary causative organism of purulent pericarditis \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Thanks to rapid diagnoses and effective treatment, the incidence of pericarditis caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in healthy children is rare; however, clinical vigilance is needed due to the high mortality rate \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn 1987, Sagrista et al. first described the characteristics and clinical manifestations of drug-responsive early CP and named it \u0026ldquo;reversible CP\u0026rdquo; \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. The clinical manifestations of Staphylococcus aureus-induced purulent pericarditis lack specificity and mostly include high fever, fatigue, chest pain, palpitations, and dyspnea. In the acute inflammatory response period, the pericardium begins to show serous and fibrinous effusion, and early drainage and anti-infection treatment are given. However, some patients may present with fibrin deposition, pericardial adhesion, and mild fibrosis in the pericardium, resulting in limited diastolic function, systemic congestion, low cardiac output, and other CP manifestations. ECG changes associated with pericarditis often depend on the effect of the damaged pericardium on the underlying myocardium. They may include QRS complexes, ST-segments, or T waves, often manifested as ST-segment elevation in the early stages and gradually evolving into T-wave inversion \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eAfter CP, cardiovascular magnetic resonance (CMR), a non-invasive imaging modality for imaging pericardial disease, often shows mild pericardial thickening, T1WI is hypointense with irregular borders, T2WI shows resolution of pericardial edema, LGE is unenhanced or only locally enhanced, and ventricular septal jitter signs may be evident on movie sequences \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. CMR imaging, in this case, showed multiple enhancements of the pericardium, accompanied by ring-shaped enhancement around the fluid area and characteristic ventricular septal jitter signs on the film sequence, which supported the diagnosis of CP.\u003c/p\u003e\u003cp\u003eIt has been reported that after MRSA-induced purulent pericarditis progressed to CP in pediatric patients, the condition was relieved by aggressive drainage of pericardial effusion and intravenous infusion of sensitive antibiotics \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. The best empirical antibiotic treatment for acute purulent pericarditis in children has not been clearly defined. The resistance rate of CA-MRSA to vancomycin and linezolid is 0 in both domestic and foreign literature, and vancomycin and linezolid are commonly used in domestic literature to report that the drugs sensitive to MRSA susceptibility test results are vancomycin and linezolid; which are the most commonly used antibiotics for the treatment of MRSA pericarditis abroad, so vancomycin or linezolid intravenous infusion is recommended for anti-infection, and the duration of antibiotics varies from 2 to 6 weeks \u003csup\u003e[\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn conclusion, this case underscores the rapid progression of a condition characterized by acute purulent and CP during MRSA infection. The patient exhibited significant improvement following a comprehensive treatment approach involving pericardial drainage, antibiotic anti-infection therapy, cardiac tonics, diuretics, vasodilators, and combined hormone therapy. Pediatric healthcare practitioners should be alert to these clinical manifestations, emphasizing early and active intervention, prudent surgical considerations, vigilant follow-up, and a multifaceted treatment strategy to optimize prognosis.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e1.Ethics approval and consent to participate:\u003c/strong\u003e This study was conducted in line with the principles of the Declaration or Helsinki. We have obtained informed consent to participate from the parents or legal guardians of participant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.Consent for publication:\u0026nbsp;\u003c/strong\u003eThe parents of this patient consented to the publication of the case and any accompanying images with written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.Clinical trial number:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.Competing interests:\u0026nbsp;\u003c/strong\u003eAll authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5.Funding\u003c/strong\u003e: This study was supported by Beijing Municipal Hospital Research and Cultivation Program (PX2024044), China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6.Author’s contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMingxu Wang: Data collection and write article\u003c/p\u003e\n\u003cp\u003eQirui Li:\u0026nbsp;Data organization and article polishing\u003c/p\u003e\n\u003cp\u003eQiang Sun: Revise the article and provide fund support\u003c/p\u003e\n\u003cp\u003eYue Yuan: Revise the article\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7.Acknowledgements:\u003c/strong\u003eThank you to every teacher who has ever helped me. I am grateful to Professor Qiang Sun for urging me to write and submit articles and providing financial support. I am also grateful to Professor Qirui Li for helping me polish my articles. And I am grateful to myself for having the courage to try again after failure.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS).European Heart Journal 2015 Nov 07;36(42).\u003c/li\u003e\n \u003cli\u003eBhattad PB, Jain V.Constrictive Pericarditis:A Commonly Missed Cause of Treatable Diastolic Heart Failure.[J].Cureus.2020 May 8;12(5):e8024.\u003c/li\u003e\n \u003cli\u003eNiraj K. Yadav, Momin S. Siddique. Constrictive Pericarditis.[J].Siddique StatPearls 2020 01.\u003c/li\u003e\n \u003cli\u003eBansal N, Walters HL 3rd , Kobayashi D.Purulent Pericarditis Due to Paronychia in a 16-Month-Old Child: A Nail-Biting Story.[J].World Journal for Pediatric and Congenital Heart Surgery,2020.Vol.11(4):NP125-NP128.\u003c/li\u003e\n \u003cli\u003eAbdel-Haq N, Moussa Z, Farhat MH, Chandrasekar L, Asmar BI.Infectious and Noninfectious Acute Pericarditis in Children: An 11-Year Experience.[J].International Journal of Pediatrics,2018,2018:5450697.\u003c/li\u003e\n \u003cli\u003eSanchez J, Schneider A, Tretter JT, Shopsin B, Al-Qaqaa Y, Khaitan A, Chadha T.Community-Acquired MRSA Pericarditis and Mediastinitis in a Previously Healthy Infant.[J].Journal of Pediatric Intensive Care,2018,7(2).\u003c/li\u003e\n \u003cli\u003eHaley JH, Tajik AJ, Danielson GK, Schaff HV, Mulvagh SL, Oh JK.Transient Constrictive Pericarditis: Causes and Natural History[J]. Journal of the American College of Cardiology. Vol. 43, No. 2, 2004.\u003c/li\u003e\n \u003cli\u003eTunuguntla H, Jeewa A, Denfield SW.Acute Myocarditis and Pericarditis in Children.[J].Pediatrics In Review,2019,40(1).\u003c/li\u003e\n \u003cli\u003eO\u0026apos;Connor MJ. Imaging the itis: endocarditis, myocarditis, and pericarditis.[J].Current Opinion In Cardiology,2019,34(1).\u003c/li\u003e\n \u003cli\u003eWang JX, Yang K, Zhao SH. The interpretation of 2020 SCMR position paper on clinical indications for cardiovascular magnetic resonance.[J].Chinese Journal of Magnetic Resonance Imaging, 2021, 12(5).\u003c/li\u003e\n \u003cli\u003eMeena DS, Kumar D, Gopalakrishnan M, Bohra GK, Midha N, Vijayvargiya P, Tiwari S. Purulent pericarditis in a patient with community-acquired methicillin-resistant Staphylococcus aureus: a case report with mini-review[J]. Germs.2020 Sep 1;10(3).\u003c/li\u003e\n \u003cli\u003eWu X, Wang CQ, He LY, Xu HM, Jing CM, Chen YH, Lin AW, Deng JK, Cao Q, Deng HL, Cai HJ, Chen YP, Yang JH, Zhang T, Huang YY, Hao JH, Yu H. Antimicrobial resistance profile of methicillin-resistant Staphylococcus aureus isolates in children reported from the ISPED surveillance of bacterial resistance, 2016-2021[J]. Front Cell Infect Microbiol,2023 Jan 19;13:1102779.\u003c/li\u003e\n \u003cli\u003eKong LM, Yang X, Qian SY, Dong F, Liu YC, Wang LJ,Yao KH, Song WQ.Molecular biological characteristics and antimicrobial resistance of Staphylococcus aureus isolated from children with pneumonia.[J]. Chinese Journal of Applied Clinical Pediatrics. 2020,35(4).\u003c/li\u003e\n \u003cli\u003eGu L, Lai GX, Lin DS, Yu ZY, Ye J, Liu W.Prevalence status and microbiological characteristics of community-associated methicillin-resistant Staphylococcus aureus infection.[J] International Journal of Respiration. 2021,41(3).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"methicillin-resistant, Staphylococcus aureus, children, reversible, constrictive pericarditis","lastPublishedDoi":"10.21203/rs.3.rs-7050032/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7050032/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction: \u003c/strong\u003eReversible Constrictive pericarditis (CP) is a rare condition characterized by thickening, adhesions, and calcification of the pericardium, causing diastolic restriction, decreased cardiac output, and potential heart failure (Constrictive pericarditis symptoms), though uncommon, exist and can be relieved with drug therapy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Presentation: \u003c/strong\u003eClinical data from a child with reversible chest CP were retrospectively analyzed. The child presented with rapid onset, persistent fever despite general anti-infective treatment, chest pain, and shortness of breath. Pericardial etiology, specifically methicillin-resistant Staphylococcus aureus, was identified. The condition significantly improved after comprehensive treatment, including anti-infective measures, cardiac care, pericardiocentesis, and drainage, yielding a favorable prognosis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eStaphylococcus aureus infection can lead to reversible CP. Early detection and Active treatment are effective, and medical staff should be vigilant for similar cases.\u003c/p\u003e","manuscriptTitle":"Reversible constrictive pericarditis in children: a case report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-25 06:21:39","doi":"10.21203/rs.3.rs-7050032/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"dcfe6f67-5a47-42dd-bbff-b3f41dbae490","owner":[],"postedDate":"July 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-17T10:09:01+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-25 06:21:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7050032","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7050032","identity":"rs-7050032","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}