BMJ Case Reports 2017; doi:10.1136/bcr-2017-219498

Purulent pericarditis as a complication of bacteraemic Enterococcus faecalis urinary tract infection

  1. Jing Liu2
  1. 1Department of Internal Medicine, Kansas University School of Medicine—Wichita, Wichita, Kansas, USA
  2. 2Department of Pulmonary and Critical Care Medicine, Kansas University School of Medicine—Wichita, Wichita, Kansas, USA
  1. Correspondence to Dr Fredy Nehme, nehme.fredy{at}
  • Accepted 3 March 2017
  • Published 15 March 2017


Purulent pericarditis is a rare clinical entity in the modern antibiotic era. The most common portal of entry is thought to be direct extension from a primary lung source and is usually caused by Staphylococcus aureus, Streptococcus pneumoniae or Haemophilus influenzae. We report the case of a man aged 69 years who presented with purulent pericarditis due to Enterococcus faecalis likely caused by haematogenous spread from a urinary tract source. Urgent pericardiocentesis was vital and restored his haemodynamic stability. He was treated for a total duration of 4 weeks with susceptible antibiotics. Echocardiography 3 weeks later showed persistent resolution of the pericardial effusion. This case shows that prompt diagnosis and drainage of the pericardial effusion are vital to achieve a positive outcome in purulent pericarditis. To the best of our knowledge, this is the first reported case of purulent pericarditis caused by E. faecalis from a urinary tract source.


  • Contributors FN and JG is responsible for drafting of the manuscript and acquisition of data. JL is responsible for critical revision and supervision of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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