Journal Article Review Epublish
PubMed: 42487835 DOI: 10.7759/cureus.113141
Purulent Pericardial Effusion: An Elusive Diagnosis.
Cureus 18(7):e113141
Authors: Shaker Al-Nabulsi, Dania Hammadi, Ahmed Abozenah, Mohammed Abozenah, Julia Ladna
Affiliations
- Medicine, Royal College of Surgeons in Ireland - Bahrain, Muharraq, BHR.
- Internal Medicine, Newgiza University, Cairo, EGY.
- Cardiovascular Medicine, University of Massachusetts Medical School - Baystate Medical Center, Springfield, USA.
- Cardiovascular Medicine, Baystate Medical Center, Springfield, USA.
Abstract
Purulent pericardial effusion (PPE) is a life-threatening infection of the pericardial space. While rare in the modern antimicrobial era, its rapidly progressive course, diagnostic challenges, and lack of management guidance make it a source of significant morbidity and mortality. Gram-positive bacteria are the most common causative organisms; however, polymicrobial and fungal infections are being increasingly recognized. Rapid diagnosis requires a high index of suspicion supported by clinical findings, pericardial fluid analysis, and imaging studies. Prompt drainage of the infected pericardial fluid along with early antimicrobial therapy remain the cornerstones of management, although gaps on optimal treatment duration, need for surgical intervention, and follow-up persist. This review aims to bridge some of these gaps by examining the current literature on purulent pericardial effusion, highlighting the epidemiology, microbiology, clinical manifestations, diagnostic challenges, management strategies, and both short-term and long-term outcomes of this deadly condition.
MeSH
Pericardial Fluid, Pericardiocentesis, Pericardial Effusion, Coinfection, Pericarditis, Tuberculous, Cardiac Tamponade, Diagnosis, Therapeutics, Infections