Abstract:
Introduction: Purulent pericarditis poses diagnostic and therapeutic challenges, especially in resource-limited
settings due to the unavailability of diagnostic tools, equipment, and expertise.
Case report: A three-year-old female presented to the emergency centre at Muhimbili National Hospital in Dar es
Salaam, Tanzania with altered mental status, lethargy, intermittent fevers, worsening difficulty in breathing, and
progressive lower extremity swelling over two months. The child was in shock upon arrival. Point-of-care ultrasound
demonstrated cardiac tamponade secondary to purulent pericarditis. An ultrasound guided pericardiocentesis
and lavage was successfully done in the emergency centre and antibiotics were started. Though
definitive management (pericardiectomy) was delayed, the child survived to hospital discharge.
Conclusion: Pericardiocentesis, pericardial lavage, and the initiation of broad spectrum antibiotics are the
mainstay of early treatment of purulent pericarditis. This treatment can be done safely in an emergency centre
with little specialised equipment aside from point-of-care ultrasound
