RESUMO
Purulent pericarditis was rarely primitive and commonly it was the spread from a contiguous focus of infection within the chest. We describe a case of a primitive purulent pericarditis due to Staphylococcus aureus septicaemia. GA, 21 years old men, admitted for chest pain and fever due to a Staphylococcus aureus septicemia. Iterative echocardiography showed a discreet clear circumferential pericardial effusion rapidly growing becoming shady and appearance of a right atrium thrombi. Transoesophageal echocardiography showed no valvular abnormalities and confirm the right atrium thrombi attached to the atrial septum. The septic syndrome persist despite suitable antibiotic therapy and the patient presented a shortness of breath due to a pulmonary embolism over an anticoagulation therapy. Later pericardial effusion become important and impressive. The surgical drainage of a purulent fluid was performed. The further course was favourable and the patient was discharged after 5 weeks without signs of ongoing infection or pericarditis. Nine month later, he was asymptomatic and trans-thoracic echocardiography showed no pericardial effusion or sign of constrictive pericarditis