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Beyond Pneumonia: A Rare Case of Pericardial Empyema Caused by Streptococcus pneumoniae

Harish Ashok1, Reginald Manuel1, Bushra Ahmed2

  • 1Internal Medicine, Ross University School of Medicine, Barbados, USA.

Cureus
|July 17, 2023
PubMed

Insights

Purulent pericardial effusion is a rare, serious condition. This case report details an unusual instance in an immunocompetent patient, emphasizing prompt diagnosis and treatment for better outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Purulent pericardial effusion (PPE) is a rare, life-threatening condition often associated with compromised immunity, dialysis, or thoracic surgery.
  • Bacterial infections are the predominant etiology of PPE, necessitating urgent medical intervention to prevent severe complications.

Observation:

  • This case report describes an unusual presentation of PPE in a 58-year-old male with a robust immune system.
  • The patient developed PPE, endocarditis, and pneumonia concurrently.
  • All conditions were linked to septic arthritis of the knee caused by Streptococcus pneumoniae.

Findings:

  • The case highlights an atypical etiology of PPE in an immunocompetent individual.
  • Streptococcus pneumoniae was identified as the causative agent, originating from septic arthritis.
  • The patient experienced multiple serious infections, including purulent pericardial effusion, endocarditis, and pneumonia.

Implications:

  • This case underscores the importance of considering diverse etiological factors for PPE, even in immunocompetent patients.
  • Early detection and prompt, comprehensive management are critical for improving patient prognosis and preventing catastrophic outcomes.
  • The findings emphasize the need for a thorough diagnostic workup to identify the source of infection in complex cases of purulent pericardial effusion.
Keywords:
bacterial pericarditisinternal medicine-cardiologylandmark-guided pericardiocentesispurulent pericarditisrecurrent pericardial effusionseptic arthritsstreptococcus pneumonaie

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