A Complex Case of Idiopathic Purulent Pericarditis in an Immunocompetent Adult

Acute purulent pericarditis is a fatal complication of bacterial pericarditis. Purulent pericarditis usually arises secondary to an infection that spreads directly or hematogenously. The mortality rate reaches 100% in untreated purulent pericarditis. We present a case of complex idiopathic purulent pericarditis caused by Methicillin-sensitive Staphylococcus aureus (MSSA). In this report a 39-year-old male presented with shortness of breath, cough and chest pain. He was diagnosed with pericardial effusion with signs of cardiac tamponade. He underwent pericardiocentesis and aspirated pericardial fluid grew Staphylococcus aureus. He was started on IV antibiotics. However, he had a recollection of pericardial fluid and thus a pericardial window and removal of fibrinous material was done. He was treated with IV antibiotics for a total of seven weeks. High clinical suspicion is needed in diagnosing purulent pericarditis and prompt treatment helps in achieving favorable outcomes for the patient as demonstrated in our case.