Surgical management of purulent pericarditis with diagnostic assistance from fluorodeoxyglucose positron emission tomography/computed tomography

Although purulent pericarditis is rare in the modern era, early diagnosis and appropriate therapy with antibiotics and drainage are critical because it remains a rapidly progressive and highly fatal infection. Purulent pericarditis typically occurs as a secondary infection through hematogenous dissemination or contiguous spread from an intrathoracic infection, with most cases occurring in immunocompromised individuals. Herein, we report the case of a 52-year-old male patient with a history of diabetes mellitus who had difficult-to-diagnose chest pain. He was ultimately diagnosed with purulent pericarditis using ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography, then treated via surgical drainage, pericardiectomy, and long-term antibiotic therapy.