A case of non-ST elevation MI with revascularization by PCI complicated by bacterial pericarditis

Abstract

Introduction: Pericarditis, an inflammation of the pericardial sac, can stem from various causes, including idiopathic, viral, and infectious origins. While viral and idiopathic cases are common in developed countries, tuberculosis is a leading cause in developing regions. Purulent bacterial pericarditis usually follows surgery or bacteremia. Post-myocardial infarction (MI) pericarditis occurs in early and late phases, the latter known as Dressler’s syndrome. This case report presents a rare occurrence of purulent bacterial pericarditis after percutaneous coronary intervention (PCI). Case Report: Our case describes a 57-year-old male with coronary artery disease (CAD), hypertension, and a recent upper respiratory tract infection (URTI) who presented with severe left shoulder pain. He was diagnosed with an acute MI and underwent PCI. Post-procedure, he developed increasing leukocytosis, fever, and respiratory distress. Despite initial broad-spectrum antibiotics, his condition necessitated further imaging and eventually pericardiocentesis, which revealed Methicillin-sensitive Staphylococcus aureus (MSSA) infection. Targeted antibiotic therapy led to his clinical improvement. Conclusion: This case highlights the necessity for vigilant differential diagnosis and prompt treatment of rare but serious complications such as bacterial pericarditis following PCI.