Asymptomatic bacteriuria as a warning sign of purulent pericardial effusion in a patient with systemic lupus erythematosus: a case report

This case highlights an atypical presentation of purulent pericardial effusion due to methicillin-sensitive Staphylococcus aureus in a patient with systemic lupus erythematosus. Purulent pericardial effusions can present with nonspecific symptoms, and the diagnosis may be obscured in critically ill patients with multiple active processes contributing to a shock state. As methicillin-sensitive Staphylococcus aureus is an uncommon bacteria to be found in the urine, it may be a warning sign of disseminated infection in immunocompromised patients and should prompt further work-up. In addition, point-of-care ultrasound can serve as a valuable tool in identifying tamponade physiology and prompting timely intervention. Clinicians should be alert to the possibility of purulent pericardial effusion in immunocompromised patients with methicillin-sensitive Staphylococcus aureus bacteremia.