Acute purulent pericarditis treated conservatively with intrapericardial fibrinolysis and intrapericardial and systemic antibiotics

Purulent pericarditis is rare, and the mortality rate is very high. Conservative management consists of pericardial drainage and antibiotic therapy. We report a case of purulent pericarditis on top of chest infection in a man presenting with dyspnea, productive cough, fever, and hypotension. Echocardiography revealed a large pericardial effusion with signs of tamponade. He was treated with pericardiocentesis along with intrapericardial fibrinolysis with streptokinase and intrapericardial and systemic antibiotics. A year later, there was no sign of constriction.