A rare case of pyogenic pericarditis secondary to Streptococcus constellatus

BMJ Case Rep. 2018 Mar 28;2018:bcr2017223804. doi: 10.1136/bcr-2017-223804.


We report an extremely rare case of purulent pericarditis caused by the normally commensal oral flora, Streptococcus constellatus, a viridans Streptococcal species and member of the S. anginosus group (previously also known by the eponymous 'S. milleri', for American Willoughby Dayton Miller). This case is a previously healthy 71-year-old immunocompetent woman from Arizona who presented with a 5-day history of progressive shortness of breath and chest tightness, and subjective fever and chills, but without history of nausea, vomiting, night sweats, recent travel, autoimmune disease or sick contacts. Early recognition and intervention of purulent pericarditis allow patients like the one outlined in this case to achieve full recovery.

Keywords: infectious diseases; pericardial disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Ceftriaxone / therapeutic use
  • Diagnosis, Differential
  • Echocardiography
  • Female
  • Humans
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / drug therapy
  • Pericardial Effusion / microbiology
  • Pericarditis / diagnostic imaging*
  • Pericarditis / drug therapy
  • Pericarditis / microbiology*
  • Pericardium / diagnostic imaging
  • Pericardium / microbiology
  • Streptococcal Infections / complications*
  • Streptococcal Infections / diagnostic imaging
  • Streptococcal Infections / drug therapy
  • Streptococcus constellatus / isolation & purification*
  • Tomography, X-Ray Computed


  • Anti-Bacterial Agents
  • Ceftriaxone