{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:08:40Z","timestamp":1780351720031,"version":"3.54.1"},"reference-count":10,"publisher":"SMC Media","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Cardiac tamponade in patients with bacterial pericarditis has a high mortality rate. A timely diagnosis is crucial and can only be achieved through repeated systematic clinical evaluation, the use of POCUS and awareness of cognitive biases in clinical reasoning. Case description:\u00a0A 56-year-old male was admitted to the emergency room with shortness of breath and chest pain. The patient became haemodynamically unstable and was treated for a septic shock. A POCUS showed signs of a cardiac tamponade, but these were not acknowledged as such. The diagnosis was delayed until the patient had a circulatory arrest. He was successfully resuscitated, and a pericardiocentesis showed a haemophilus influenzae pericarditis. The patient recovered well after pericardiocentesis and treatment with antibiotics. Discussion:\u00a0For unstable patients, it is essential to conduct systematic assessments at regular intervals and whenever there is a change in clinical status. Cardiac and lung POCUS have proved to be useful in undifferentiated shock patients. Importantly, pericardial effusion should always be ruled out. For every clinician, it is important to be aware of possible cognitive biases in clinical reasoning and to use strategies to mitigate these risks.<\/jats:p>","DOI":"10.12890\/2025_005718","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T15:50:41Z","timestamp":1762357841000},"source":"Crossref","is-referenced-by-count":1,"title":["A late diagnosis of bacterial pericarditis"],"prefix":"10.12890","volume":"12","author":[{"given":"Ibrahim","family":"Oulad Sedik","sequence":"first","affiliation":[{"name":"Department of Cardiology, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Diaz","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Cura\u00e7ao Medical Centre, Willemstad, Cura\u00e7ao"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2534-9749","authenticated-orcid":false,"given":"Jeanne J.","family":"Koeijers","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Intensive Care Medicine, Cura\u00e7ao Medical Centre, Willemstad, Cura\u00e7ao"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Molina Monsalve","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cura\u00e7ao Medical Centre, Willemstad, Cura\u00e7ao"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5481-2387","authenticated-orcid":false,"given":"Reinold","family":"Gans","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cura\u00e7ao Medical Centre, Willemstad, Cura\u00e7ao; Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"10.12890\/2025_005718_ref1","doi-asserted-by":"crossref","unstructured":"Klacsmann PG, Bulkley BH, Hutchins GM. The changed spectrum of purulent pericarditis: an 86 year autopsy experience in 200 patients. Am J Med 1977;63:666\u2013673. doi: 10.1016\/0002-9343(77)90150-4","DOI":"10.1016\/0002-9343(77)90150-4"},{"key":"10.12890\/2025_005718_ref2","doi-asserted-by":"crossref","unstructured":"Imazio M, Cecchi E, Demichelis B, Ierna S, Demarie D, Ghisio A, et al. Indicators of poor prognosis of acute pericarditis. Circulation 2007;115:2739\u20132744. doi: 10.1161\/CIRCULATIONAHA.106.662114","DOI":"10.1161\/CIRCULATIONAHA.106.662114"},{"key":"10.12890\/2025_005718_ref3","unstructured":"Spodick DH. Infectious pericarditis. In: Spodick DH, editor. The pericardium: a comprehensive textbook, New York: Marcel Dekker 1997;260\u2013290."},{"key":"10.12890\/2025_005718_ref4","doi-asserted-by":"crossref","unstructured":"Shabetai R. The pericardium. 1st ed. 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Acad Emerg Med 2002;9:1184\u20131204. doi: 10.1111\/j.1553-2712.2002.tb01574.x","DOI":"10.1197\/aemj.9.11.1184"},{"key":"10.12890\/2025_005718_ref7","doi-asserted-by":"crossref","unstructured":"Croskerry P, Singhal G, Mamede S. Cognitive debiasing 1: origins of bias and theory of debiasing. BMJ Qual Saf 2013;22:ii58\u2013ii64.doi: 10.1136\/bmjqs-2012-001712","DOI":"10.1136\/bmjqs-2012-001712"},{"key":"10.12890\/2025_005718_ref8","doi-asserted-by":"crossref","unstructured":"Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med 2003;78:775\u2013780. doi: 10.1097\/00001888-200308000-00003","DOI":"10.1097\/00001888-200308000-00003"},{"key":"10.12890\/2025_005718_ref9","doi-asserted-by":"crossref","unstructured":"Croskerry P, Singhal G, Mamede S. Cognitive debiasing 2: impediments to and strategies for change. 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