Pyopericarditis and tropical pyomyositis: unusual concomitance.

Area of Science:

• Infectious Diseases
• Cardiology
• Rheumatology

Background:

• Viral pericarditis is a common cause of chest pain in young adults.
• Bacterial superinfection can lead to severe complications.

Observation:

• A 19-year-old male presented with chest pain, initially diagnosed with viral pericarditis.
• He later developed cardiac tamponade and leg pain with fever.
• Elevated creatine kinase isoenzyme MB (CK-MB) and C-Reactive Protein (CRP) indicated myocardial and inflammatory involvement.

Findings:

• Pericardial fluid culture revealed *Staphylococcus aureus*, leading to a diagnosis of bacterial pericarditis and cardiac tamponade.
• Subsequent development of leg pain and fever, with CT findings suggestive of abscesses, indicated staphylococcal tropical myositis.
• The patient required surgical pericardial drainage, antibiotics (ceftriaxone, oxacillin), and abscess drainage.

Implications:

• This case highlights the importance of considering bacterial superinfection in presumed viral pericarditis.
• Early recognition and aggressive management of *Staphylococcus aureus* infections are critical to prevent severe morbidity.
• Co-infection with cardiac and muscular involvement underscores the systemic potential of staphylococcal infections.