une pericardite

I wanted to share an exciting "success story" from this week (and a pretty crazy xray). We had a 9 year old boy come in about two weeks ago in respiratory distress and with a high fever, and his chest xray looked like this -- a massive heart. Based on the CXR, an echo, and the clinical presentation he was diagnosed with pericarditis and the surgeons inserted a drain. (there is no capacity for bacterial cultures here, no radiologists - the docs read the xrays, and the "echocardiographer" is actually the internal med doc who happens to know how to do echos)

After the drain was inserted, he improved rapidly, his fevers diminished, and within about a week or so he was hopping around the peds ward happily playing with the other kids. We sent him home yesterday.

(At first we suspected TB, but it turned out to be a viral pericarditis)