Surgical management of pyopericardium

Forty three patients with pyopericardium were managed over a six year period. Pyomyositis and septic arthritis were the most common associated conditions and Staphylococcus aureus the commonest microorganism isolated. Mycobacterium tuberculosis was isolated in only three of the cases. Pericardiocentesis and various forms of pericardial windows were found to be associated with high rates of recurrences, inadequate drainage and subsequent constrictive pericarditis. Pericardiectomy should be done as an initial form of surgical treatment where the general condition of the patient permits, since this procedure is not associated with the adverse sequelae of aspiration and pericardial window procedures.