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A case of purulent pneumococcal pericarditis
Authors:Itay Zmora  Yonit Wiener-Well  Evan Avraham Alpert
Affiliation:1. Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel;2. Infectious Disease Unit, Shaare Zedek Medical Center, Hebrew University-Hadassah Medical School, Jerusalem, Israel
Abstract:

Background

Purulent bacterial pericarditis is a rare and potentially fatal disease. The course may be fulminant, and the presentation may pose a diagnostic challenge.

Case report

An otherwise healthy 75-year-old male was brought to the emergency department in a state of general deterioration, confusion, and shock. Bedside ultrasound showed a significant pericardial effusion. His condition quickly deteriorated and the resuscitation included emergent bedside pericardiocentesis. The drainage was purulent and later cultures grew out Streptococcus pneumoniae.

Why should an emergency physician be aware of this?

Purulent pericarditis is extremely rare but should be considered in the patient with a fulminant infectious process (particularly pneumonia) and signs of pericardial effusion. Treatment should include appropriate antibiotics and early drainage.
Keywords:Ultrasound, diagnostic  Emergency department  Pericardiocentesis  Pericarditis  Corresponding author.
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