This case report describes the first documented instance of recurrent MSSA-induced purulent pericarditis with massive fluid reaccumulation (3,875 ml total) in a patient with concurrent SARS-CoV-2 infection, highlighting the critical role of aggressive serial pericardial drainage and targeted antibiotic therapy.
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Alerts clinicians to purulent pericarditis risks; leaves open optimal management in culture-negative cases.
Purulent pericarditis (PPc) is a rare but clinically significant form of pericarditis that is typically associated with severe infection. Diagnosis is made by aspirating purulent fluid from the pericardial space, although cultures or gram stains of this fluid often yield negative results. Early detection and treatment are important in preventing severe complications such as cardiac tamponade, persistent infection, and the need for advanced therapies. This report describes the case of a 56-year-old man with multiple comorbidities, including diabetic ketoacidosis, COVID-19, and methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia, who was diagnosed with PPc after developing early cardiac tamponade and undergoing successful pericardiocentesis.
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Gerlt et al. (2025) studied this question.
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