Intraperikardiale Fibrinolyse als therapeutische Option bei der Perikarditis purulenta

HISTORY AND ADMISSION FINDINGS: A 23-year-old man known to have Hodgkin's disease in remission and C-protein deficiency presented with chest pain and symptoms of respiratory infection. INVESTIGATIONS: A purulent pericardial effusion was detected by echocardiography. The chest X-ray showed a left-sided pneumonia. TREATMENT AND CLINICAL COURSE: When pericardiocentesis failed to drain the purulent but pathogen-free effusion completely, streptokinase was several times instilled intrapericardially and achieved fibrinolysis without complication. The effusion did not recur. CONCLUSIONS: Intrapericardial application of fibrinolytic agents seems to be an effective treatment of a purulent pericarditis.