# Non-tamponade Indications for Pericardial Drainage: A Case Report of Acute Streptococcus pneumoniae Purulent Pericarditis

## TL;DR

A case report shows pericardial drainage helped a patient with bacterial pericarditis even without heart compression.

## Contribution

Demonstrates a non-tamponade use of pericardial drainage in treating acute bacterial pericarditis.

## Key findings

- Pericardial drainage was beneficial in a patient without cardiac tamponade.
- The patient had acute Streptococcus pneumoniae-induced purulent pericarditis.
- The procedure was effective despite absence of typical tamponade physiology.

## Abstract

Pericardial drainage is a procedure completed to evacuate fluid from the pericardial space. This can be completed by pericardiocentesis or pericardial window. These procedures are most often done in the setting of cardiac tamponade, typically to correct low blood pressure due to low stroke volume from extrinsic compression of the heart chambers by the pericardial fluid. Elective pericardiocentesis can be done in cases where fluid accumulation is secondary to pathological processes, including hemopericardium secondary to complications of trauma to the chest, toxins, myocardial infarction, cardiac surgery, serosanguinous pericardial effusion due to malignancy, right heart failure, acute pericarditis, chemotherapeutic agents, metabolic derangements like uremia, and autoimmune disorders. Here, we report a case of a 66-year-old immunocompetent male with acute bacterial pericarditis resulting in fibrinous pericardial effusion without echocardiographic cardiac tamponade physiology in whom pericardial drainage proved beneficial.