A Rare Case of Streptococcus pneumoniae Complicated With Pericardial Abscess

Abstract

This abstract presents the case of a 37-year-old female with no significant past medical history who presented to the emergency department with a unique and challenging clinical scenario. The patient complained of chest pain, dyspnea, and a productive cough associated with stabbing chest pain that improved with leaning forward for the past week. Despite an initial diagnosis of community-acquired pneumonia, the patient's condition deteriorated rapidly, leading to septic shock. Blood cultures ultimately revealed Streptococcus pneumoniae as the causative organism. Subsequent imaging and diagnostic procedures demonstrated a complex clinical course, including loculated pleural and pericardial effusions. The patient's condition necessitated multiple interventions, including pericardiocentesis, chest tube placement, and intracavitary lytic therapies, in addition to intubation for acute respiratory failure. The case further evolved with the development of a pericardial abscess, successfully managed with surgical drainage and a partial pericardiectomy. The patient eventually showed significant clinical improvement and was discharged on a targeted antibiotic regimen. This case highlights the importance of vigilance in identifying rare complications of pneumonia and the need for prompt, multidisciplinary management to ensure the best possible outcome for the patient. Long-term follow-up was recommended to assess the patient's recovery. This case underscores the complexities and challenges of managing uncommon presentations of infectious diseases and emphasizes the value of a comprehensive, multidisciplinary approach in such cases.

Keywords: acute pericardial effusion; community aquired pneumonia; loculated pleural effusion; pericardial tamponde; streptococcus pneumoniea.