# Successful Surgical Intervention for Purulent Pericarditis Caused by Klebsiella pneumoniae Perforating Into the Thoracic Cavity: A Case Report

## TL;DR

An 85-year-old woman with purulent pericarditis caused by Klebsiella pneumoniae was successfully treated with surgical drainage and curettage.

## Contribution

This case report highlights the successful surgical management of a rare and severe pericardial infection.

## Key findings

- Surgical intervention including pericardial and intrathoracic curettage effectively treated purulent pericarditis.
- Early drainage and surgery were crucial in preventing recurrence and saving the patient's life.
- Intraoperative findings confirmed communication between the pericardial space and thoracic cavity.

## Abstract

Purulent pericarditis is an infection of the pericardial space surrounding the heart especially caused by bacteria. An 85-year-old woman was brought to the emergency room with sudden chest pain. Chest x-ray showed cardiac hypertrophy, and a computed tomography (CT) scan revealed an air-fluid level in her pericardium and a small amount of left pleural effusion. CT scan on the day after admission showed a marked increase in left pleural effusion. The left intercostal drain yielded Klebsiella pneumoniae and based on these findings, surgery including pericardial and intrathoracic curettage was contemplated. Intraoperative findings showed communication between the pericardial space and the thoracic cavity. After curettage and irrigation of the pericardial space and thoracic cavity, the pericardial space was opened, and the surgery was completed. The patient’s postoperative course was uneventful. Thereafter, no recurrence or exacerbation was observed. Early pericardial and thoracic drainage followed by surgical treatment were deemed crucial in saving the patient's life.