Polymicrobial purulent pericarditis and peritoneal effusion in an immunocompromised patient with Staphylococcus aureus bacteraemia : a case report

Cmor, Nino (author), Dora, Eva (author), Lainščak, Mitja (author), Tibaut, Miha (author)

Background: Polymicrobial pericarditis is an extremely rare and lethal form of pericarditis. Prompt initiation of appropriate antimicrobial treatment and pericardial drainage are crucial. Case summary: A 57-year-old immunocompromised male patient presented to the emergency department due to dyspnoea, chest pain, and fever lasting for 7 days. Following clinical, laboratory, and imaging work-up, he was found to have pericardial effusion with signs of tamponade. After pericardiocentesis through subxiphoid and apical approaches, 800 mL of gross purulent fluid was obtained. Blood and pericardial fluid cultures confirmed the diagnosis of polymicrobial purulent pericarditis (Staphylococcus aureus and Bacteroides vulgatus). Further work-up revealed minor peritoneal effusion, and paracentesis fluid culture revealed the presence of S. aureus and, additionally, Candida albicans. After treatment initiation with intravenous antibiotics, pericardial, drainage and supportive measures, the patient's condition initially improved despite the development of constrictive pericarditis. However, he suddenly deteriorated after 37 days of hospitalization and passed away after 51 days of hospitalization. Discussion: To the best of our knowledge, this is the first report of purulent pericarditis and purulent peritoneal effusion in the settings of S. aureus bacteraemia with an absent primary infection focus. Clinicians should be aware of treatment options for purulent pericarditis and consider intrapericardial fibrinolysis, especially in patients not suited for more invasive pericarditis treatment.

• Language: English
• Keywords: polymicrobial pericarditis, case report, pericardiocentesis, Staphylococcus aureus bacteraemia, tamponade
• Work type: Article
• Typology: 1.03 - Other scientific articles
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: 5 str.
• Numbering: Vol. 8, no. 9, art. ytae427
• PID: 20.500.12556/RUL-183021
• UDC: 616.1
• ISSN on article: 1879-0844
• DOI: 10.1093/ehjcr/ytae427
• COBISS.SI-ID: 225957891
• Publication date in RUL: 02.06.2026

Record is a part of a journal

• Title: European journal of heart failure
• Shortened title: Eur. j. heart fail.
• Publisher: Elsevier
• ISSN: 1879-0844
• COBISS.SI-ID: 23170053

Licences

• License: CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
• Link: http://creativecommons.org/licenses/by-nc/4.0/
• Description: A creative commons license that bans commercial use, but the users don’t have to license their derivative works on the same terms.

Secondary language

• Language: Slovenian
• Keywords: polimikrobni perikarditis, prikaz primera, perikardiocenteza, Staphylococcus aureus bakteriemija, tamponada