• Jose Carlos Flores-González, Fernando Rubio-Quiñones, Arturo Hernández-González, Moisés Rodríguez-González, Jose Antonio Blanca-García, Alfonso María Lechuga-Sancho, and Sebastián Quintero-Otero.
• From the *Pediatric Intensive Care Unit, †Pediatric Cardiology Unit, and ‡Pediatric Research, Hospital Universitario Puerta del Mar, Cádiz, Spain.
• Pediatr Emerg Care. 2014 Aug 1;30(8):552-4.

AbstractBacterial pericarditis in children has become a rare entity in the modern antibiotic era. The most common pathogen is Staphylococcus aureus, being Streptococcus pneumoniae an exceptional cause. We present 2 children, who were diagnosed of pneumonia complicated with a pleural effusion that developed a purulent pericarditis with signs of cardiac tamponade. One of them had received 4 doses of the 7-valent conjugated pneumococcal vaccine. Systemic antibiotics and pericardial and pleural drainages were used. Pneumococcal antigens were positive in pleural and pericardial fluids in both cases, and S. pneumoniae was isolated from pleural effusion in one of them. Both children fully recovered, and none of them developed constrictive pericarditis, although 1 case presented a transient secondary left ventricular dysfunction. Routine immunization with 10- and 13-valent vaccines including a wider range of serotypes should further decrease the already low incidence.

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