[Rapid transition from purulent to constrictive pericarditis]

A 48-year-old woman experienced a high fever and precordial pain. Computed tomography revealed pericardial fluid, and she was diagnosed with viral pericarditis. The pericardial fluid gradually increased, and she experienced pre-shock. Pericardial drainage was therefore performed, and the fluid was found to be purulent on the 11th day. Pleural effusion and ascites retention, then increased, and she was diagnosed with constrictive pericarditis on the 21st day by the date of the right ventricular pressure. Excision of the pericardium was performed through median sternotomy on the 27th day after the onset. As the ventricular diastolic function improved, the heart swelled, and sternal closure became impossible. It was finally closed 5 days after the surgery. The patient had no recurring infection, and was discharged on the 36th postoperative day. Although purulent pericarditis is a rare disease, you should keep in mind that it may progress rapidly to constrictive pericarditis.