Acute purulent pericarditis is infrequent in children. Only around 200 cases have been reported in the western literature in the past 25 years (1-10). From the Scandinavian countries only two cases have been described (6, 7). Purulent pericarditis is usually a complication of upper respiratory tract infection. Mortality is very high in unrecognized or inadequately treated cases. Early diagnosis and appropriate treatment with adequate surgical drainage and antimicrobial therapy are vitally important for the outcome.