Een meisje met dyspneu en een vergrote lever

Julia M. J. van der Zande, Ellen Vanhie, Bart Straver, Tijs A. Stehmann, Marc van Heerde, Jeroen Hol

Research output: Contribution to journalArticleProfessional


BACKGROUND: During winter, the influenza and Respiratory Syncytial Virus season, children are often seen in the emergency department with fever and respiratory symptoms. CASE DESCRIPTION: We describe the case of a 2-year-old girl with fever, dyspnea and signs of heart failure during physical examination. Echocardiogram showed a large amount of pericardial effusion with signs of cardiac tamponade. Pericardiocentesis showed 200 ml purulent liquid. Surgical drainage was performed. However pericardial effusion recurred. Because constrictive pericarditis was feared, a pericardiectomy was performed after which the patient recovered. Cultures showed Haemophilus influenzae type b and the patient was treated with amoxicillin for 4 weeks in total. CONCLUSION: Fever and dyspnea may also be caused by a problem outside the respiratory system. With physical examination a cardiac cause, such as pericarditis, can be detected. An ECG is easily obtained and can help in the differential diagnosis. An echocardiogram can confirm the diagnosis.
Original languageDutch
JournalNederlands Tijdschrift voor Geneeskunde
Publication statusPublished - 21 Oct 2021

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