Pericardial drainage and continuous irrigation for a patient with purulent pericarditis caused by Streptococcus anginosus

Pericarditis is a rare, rapidly progressing, life-threatening condition. A 49-year-old Japanese woman presented with heart failure resulting from cardiac effusion secondary to purulent pericarditis (bacterial pyogenic pericarditis) caused by Streptococcus anginosus. The patient required emergency pericardial drainage and irrigation. We report this case and discuss the available treatment options for this disease.

Learning objectives

Purulent pericarditis accounts for less than 1 % of all acute pericarditis cases because treatment methods against causative bacteria have already been established. However, purulent pericarditis continues to result in a poor prognosis and high mortality. Streptococcus anginosus, one of the normal floras can also induce purulent pericarditis, and we recommend pericardial drainage and continuous irrigation in addition to antibiotics as early as possible after the diagnosis, especially in patients with worsening of general condition.