Clinical Practice and Cases in Emergency Medicine

Introduction: Purulent pericarditis is a rare subset of pericarditis that can result in serious morbidity and mortality. Presenting symptoms are often nonspecific, and a high index of suspicion must be maintained to reach an early diagnosis. Point-of-care ultrasound can be pivotal in the emergency department evaluation of purulent pericarditis, providing key information including characteristics of the effusion and a sonographic assessment for signs of tamponade. We present a case of purulent pericarditis first detected using point-of-care ultrasound in the emergency department. 

Case Report: A 55-year-old male presented with chest pain and dyspnea and was found to have cardiac tamponade secondary to purulent pericarditis.

Conclusion: Cases of purulent pericarditis are rare but should be recognized by emergency clinicians. Point-of-care ultrasound is a powerful tool to assist in early diagnosis of pericardial effusion, allowing assessment for signs of cardiac tamponade. Early management with broad spectrum antibiotics and cardiology consultation are mainstays of treatment and can significantly improve outcomes.