DOI: 10.12890/2025_005718

A late diagnosis of bacterial pericarditis

Authors

  • Ibrahim Oulad Sedik Department of Cardiology, Amphia Hospital, Breda, The Netherlands
  • Ruben Diaz Department of Emergency Medicine, Curaçao Medical Centre, Willemstad, Curaçao
  • Jeanne Koeijers Department of Internal Medicine and Intensive Care Medicine, Curaçao Medical Centre, Willemstad, Curaçao 0000-0002-2534-9749
  • Juan Molina Monsalve Department of Cardiology, Curaçao Medical Centre, Willemstad, Curaçao
  • Reinold Gans Department of Internal Medicine, Curaçao Medical Centre, Willemstad, Curaçao; Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands 0000-0001-5481-2387

ibrahim_ouladsedik@hotmail.com

Keywords

Bacterial pericarditis, cognitive bias

Abstract

Background: Cardiac 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: A 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: For 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.

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Published

2025-11-05

Issue

Vol. 12 No. 12 (2025)

Categories

How to Cite

1.
Oulad Sedik I, Diaz R, Koeijers JJ, Molina Monsalve J, Gans R. A late diagnosis of bacterial pericarditis. EJCRIM [Internet]. 2025 Nov. 5 [cited 2026 Nov. 3];12(12). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5718