Regional cardiac tamponade : An infectious sequelae to toxic myopericarditis?

D. Chakkravarthi; Harshal Pamecha; A.N. Senthil; D. Vinoth Kumar

Volume : IX, Issue : IV, April - 2020

Regional cardiac tamponade : An infectious sequelae to toxic myopericarditis?

D. Chakkravarthi, Harshal Pamecha, A. N. Senthil, D. Vinoth Kumar

Abstract :

Background: The term pyopericardium usually denotes pus in otherwise a sterile pericardial cavity.This entity is rare now–a–days. Report of the case : A 52 year old diabetic male admitted with left sided noncardiac chest pain had history of celphos ingestion 1 month back during which he developed myopericarditis and defaulted treatment. On current admission patient was hemodynamically unstable in cardiogenic shock with echocardiography suggested of left ventricular diastolic collapse due to large loculated pericardial collection hyperechoic nature posterior to left ventricle. Patient was subjected to emergency pericardiocentesis and pericardial fluid analysis suggested purulent nature with significant elevated ADA levels. Following maximum complete drainage of purulent pericardial collection, patient was started on antitubercular treatment with steroids and gradually improved over the course of treatment. Conclusion: The treatment of pyopericardium includes intensive intravenous antibiotics with/without surgical drainage of pus. Standard anti tuberculosis regimen has to be given for tubercular pyopericardium.