Article Text

Pyopericardium presenting with echocardiographic features of pericardial tamponade in an elderly man
  1. Jih Huei Tan1,
  2. Zi Qin Ng2,3,
  3. Henry Chor Lip Tan1,
  4. Simon Vendargon1
  1. 1Department of Cardiothoracic Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
  2. 2Royal Perth Hospital, Perth, Western Australia, Australia
  3. 3Department of General Surgery, St John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia
  1. Correspondence to Dr Zi Qin Ng, kentng{at}


A 72-year-old Chinese man presented with mild symptoms of heart failure. Transthoracic echocardiography showed signs of cardiac tamponade though clinically he was relatively well. The option of pericardiocentesis was not carried out due to a narrow window for aspiration with only a thin layer of effusion seen surrounding the apex and right ventricle on subcostal view.

Pericardial window was done via a left anterolateral thoracotomy. Intraoperatively, 500 cm3 of purulent fluid was drained. Microbiology screens were all negative. We present the atypical clinical course of this elderly man presenting with a large pyopericardium.

  • infectious diseases
  • pericardial disease
  • cardiovascular medicine

Statistics from


  • Contributors JHT designed the study, collected and analysed the data, drafted the article and approved the final version of the article to be published. ZQN and JHT analysed the data, revised the article and approved the final version of the article to be published. SV codesigned the study, analysed the data, critically reviewed the article, supervised the study and approved the final version of the article to be published.

  • 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.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.