BMJ Case Reports 2018; doi:10.1136/bcr-2018-225009
  • Reminder of important clinical lesson

Pyopericardium progressing to tamponade in a patient with immune thrombocytopenia

  1. John Francis John3
  1. 1Internal Medicine, Baby Memorial Hospital, Calicut, India
  2. 2Cardiothoracic and Vascular Surgery, Baby Memorial Hospital, Calicut, India
  3. 3Cardiology, Baby Memorial Hospital, Calicut, Kerala, India
  1. Correspondence to Dr Robin George Manappallil, drrobingeorgempl{at}, gm.varghese{at}
  • Accepted 27 April 2018
  • Published 16 May 2018


Pericardial effusion can develop during any stage of pericarditis, and small effusions that appear rapidly can cause cardiac tamponade. Pyopericardium is a rare aetiology for tamponade. This is a case of an elderly diabetic lady, on steroid therapy for immune thrombocytopenia, who presented with fever and acute dyspnoea. She developed cardiac tamponade due to pyopericardium with Staphylococcus as the causative organism. Staphylococcus pyopericardium, in the absence of a primary focus of infection, progressing to tamponade is an uncommon scenario.


  • Contributors MG: revision of manuscript and treating physician. RGM: concept and design of manuscript, revision of manuscript and treating physician. HN: critical revision of manuscript and treating cardiothoracic surgeon. JFJ: critical revision of manuscript and treating cardiologist.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

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

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article