Pyopericardium complicated with cardiac tamponade: an unusual presenting manifestation of primary pyomyositis.

[pyomyositis]

Primary pyomyositis is an infective condition mainly involving the skeletal muscles . Various cardiac complications reported are acute bacterial endocarditis , pyogenic pericarditis , pancarditis and , very rarely , pyopericardium presenting as cardiac tamponade . We report a case of 15 -year -old boy presenting with complaints of fever , progressive shortness of breath and retrosternal pleuritic chest pain . He also complained of painful swellings of left arm , left side of neck and left thigh extending up to the knee joint . Ultrasonography showed collections in the : bilateral sternocleidomastoid ; subclavius ; left thigh muscles ; and left knee joint . Echocardiography showed evidence of cardiac tamponade . He underwent emergent pericardiocentesis and frank pus was drained . Pus culture grew Methicillin resistant Staphylococcous aureus . With drainage and the appropriate antibiotics , he improved .