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Purulent pericarditis, an unusual cause of cardiac arrest

Kevin Green1, Stephanie Rothweiler2, Barrett Attarha3

  • 1Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of Florida Health at Jacksonville, Jacksonville, Florida, USA Kevin.Green@jax.ufl.edu.

BMJ Case Reports
|September 22, 2021
PubMed

Insights

Purulent pericarditis, a rare pus infection of the pericardial space, can be caused by Streptococcus anginosus. Prompt drainage and intervention significantly reduced patient morbidity in this case.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Critical Care Medicine

Background:

  • Purulent pericarditis is a rare but serious infection characterized by pus in the pericardial sac.
  • Prompt diagnosis and management are crucial for improving patient outcomes.

Observation:

  • A case of purulent pericarditis caused by Streptococcus anginosus is presented.
  • The patient developed obstructive and septic shock due to the infection.
  • A loculated effusion raised concerns for constrictive pericarditis.

Findings:

  • Immediate pericardial drainage led to rapid symptomatic improvement.
  • A subsequent pericardial window procedure was performed due to the loculated effusion.
  • The patient experienced reduced morbidity, contrary to the typically high fatality rate of purulent pericarditis.

Implications:

  • This case highlights the importance of early recognition and surgical intervention in managing purulent pericarditis.
  • Prompt drainage and pericardial window procedures can mitigate severe complications and reduce mortality.
  • Streptococcus anginosus should be considered in the differential diagnosis of bacterial pericarditis.
Keywords:
adult intensive careinfectious diseasespericardial disease

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