XXXX in a chronic renal failure @entity1 .

@entity1 @entity2756 @entity697 @entity868 @entity417 @entity2176 @entity75 @entity2294 @entity2396 @entity794 @entity520 @entity358 @entity6064 @entity221 @entity454
A 34-year-old female with @entity454 was admitted for severe @entity520 , @entity75 , @entity2396 and severe @entity417 following a bout of @entity697 . She improved on aggressive medical management including intensive hemodialysis and was initiated onto maintenance heparin-free hemodialysis (twelve hours per week) and discharged. After a week, she presented with @entity221 with chills and rigors for three days, was toxic, severely orthopenic and had a pulsus paradoxus of 36 mmHg. Echocardiography suggested cardiac tamponade. Aspiration revealed frank pus with polymorphonuclear predominance and @entity794 on culture. CT of the thorax revealed @entity2294 . In the absence of any obvious septic foci, concomitant @entity358 , mediastinal or intra-abdominal pathology; a diagnosis of "acute primary @entity2396 " was made. @entity1 was put on parenteral antibiotics- @entity2756 and @entity868 . @entity2176 was added after sensitivity results. Pericardial drainage was required initially. After @entity6064 improved, paradox decreased and @entity221 subsided, the pericardial catheter was removed and antibiotics continued for a period of four weeks. Maintenance hemodialysis was continued during hospital stay and after discharge.
