{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:47:41Z","timestamp":1785764861595,"version":"3.56.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Purulent pericarditis is a subtype of acute pericarditis with a high mortality even when adequately treated. Standard therapy is a combination of antibiotics and drainage, which can be more or less invasive. This is a case report of a patient with purulent pericarditis where cardiac surgery via sternotomy for thorough debridement and lavage was required for complete infection control<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 41-year-old man with a history of injected and inhaled drug use was admitted with a large pericardial effusion, and 700 mL of pus was percutaneously drained. After being started on broad spectrum antibiotics the patient remained with persistent signs of infection, and was submitted to surgical drainage and debridement via full median sternotomy. The patient improved progressively afterwards, and after agent identification and being started on intravenous penicillin, he was discharged after 4 weeks, without evidence of wound infection<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Discussion:<\/jats:title>\n                    <jats:p>An organized pleural effusion was likely the cause of the purulent pericarditis. Of all invasive treatment options available, full median sternotomy was considered the most appropriate for this patient, as it allowed for maximal exposure for debridement. Even though the patient was operated in an actively infected state, there was no wound infection or dehiscence, in part because of meticulous perioperative wound care<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Purulent pericarditis is a fatal disease, and cardiac surgery via full median sternotomy may be necessary and at times the most appropriate for adequate complete treatment, as it is simple, easily reproducible, and with an acceptable risk of wound infection<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/rc9.0000000000000005","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:21:24Z","timestamp":1768396884000},"page":"129-132","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Difficult to treat purulent pericarditis \u2013 where does full sternotomy stand? A case report"],"prefix":"10.1097","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5690-502X","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Aquino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas","family":"Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Roque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"R1-20260803","doi-asserted-by":"crossref","first-page":"2739\u201344","DOI":"10.1161\/CIRCULATIONAHA.106.662114","article-title":"Indicators of poor prognosis of acute pericarditis","volume":"115","author":"Imazio","year":"2007","journal-title":"Circulation"},{"key":"R2-20260803","first-page":"519\u201322","article-title":"Purulent pericarditis caused by group a streptococcus","volume":"33","author":"Bhaduri-mcintosh","year":"2006","journal-title":"Tex Heart Inst J"},{"key":"R3-20260803","first-page":"2921\u201364","article-title":"ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS)","volume":"36","author":"Adler","year":"2015","journal-title":"Eur Heart J"},{"key":"R4-20260803","doi-asserted-by":"crossref","first-page":"1185\u201387","DOI":"10.1097\/PEC.0b013e31823b44af","article-title":"Purulent pericarditis in children: is pericardiotomy needed?","volume":"27","author":"Megged","year":"2011","journal-title":"Pediatr Emerg Care"},{"key":"R5-20260803","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/cc10022","article-title":"Clinical review: intrapericardial fibrinolysis in management of purulent pericarditis","volume":"15","author":"Augustin","journal-title":"Crit Care"},{"key":"R6-20260803","doi-asserted-by":"crossref","first-page":"17","DOI":"10.31083\/j.rcm2401017","article-title":"Fibrinolytic Therapy in Purulent Pericarditis","volume":"24","author":"Dybowska","year":"2023","journal-title":"Rev Cardiovasc Med"},{"key":"R7-20260803","doi-asserted-by":"crossref","first-page":"1661\u201365","DOI":"10.1016\/0735-1097(93)90592-O","article-title":"Purulent pericarditis: review of a 20-year experience in a general hospital","volume":"22","author":"Sagrist\u00e0-Sauleda","year":"1993","journal-title":"J Am Coll Cardiol"},{"key":"R8-20260803","doi-asserted-by":"crossref","first-page":"518\u201321","DOI":"10.1089\/lap.2006.16.518","article-title":"Thoracoscopic pericardiectomy for purulent pericarditis: experience with 21 cases","volume":"16","author":"Liem","year":"2006","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R9-20260803","first-page":"100079","article-title":"Revised Surgical CAse REport (SCARE) guideline: An update for the age of Artificial Intelligence","volume":"10","author":"Kerwan","year":"2025","journal-title":"Prem J Sci"},{"key":"R10-20260803","doi-asserted-by":"crossref","first-page":"414\u201318","DOI":"10.1111\/hdi.13219","article-title":"Purulent Pericarditis as an Initial Manifestation of Infective Endocarditis in a Hemodialysis Patient: A Case Report","volume":"29","author":"Gracia-Ramos","year":"2025","journal-title":"Hemodial Int"},{"key":"R11-20260803","first-page":"6311\u201316","article-title":"Purulent pericarditis and cardiac tamponade in HIV: a case report on a dreaded complication of Streptococcus pneumoniae","volume":"86","author":"Wagle","journal-title":"Ann Med Surg (Lond)"},{"key":"R12-20260803","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13256-024-05014-z","article-title":"Pyopericardium with cardiac tamponade caused by pyogenic liver abscess: a case report","volume":"19","author":"Steffen","year":"2025","journal-title":"J Med Case Rep"},{"key":"R13-20260803","doi-asserted-by":"crossref","first-page":"3199\u2013205","DOI":"10.2147\/IDR.S530643","article-title":"Purulent Pericarditis and Septic Shock Caused by Nontypeable Haemophilus Influenzae in an Immunocompromised Patient: A Case Report","volume":"18","author":"Hori","year":"2025","journal-title":"Infect Drug Resist"},{"key":"R14-20260803","doi-asserted-by":"crossref","first-page":"100726","DOI":"10.1016\/j.tcr.2022.100726","article-title":"Delayed traumatic purulent pericarditis with cardiac tamponade - A rare case report","volume":"42","author":"Liao","year":"2022","journal-title":"Trauma Case Rep"},{"key":"R15-20260803","first-page":"5\u201310","article-title":"Prevention of pericardial constriction by transcatheter intrapericardial fibrinolysis with urokinase","volume":"20","author":"Cui","year":"2005","journal-title":"Chin Med Sci J"},{"key":"R16-20260803","doi-asserted-by":"crossref","first-page":"962\u201372","DOI":"10.1016\/j.jtcvs.2016.01.060","article-title":"Prevention and management of sternal wound infections","volume":"152","author":"Lazar","year":"2016","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:05:51Z","timestamp":1785762351000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/rc9.0000000000000005","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]},"assertion":[{"value":"2025-08-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}