Bronchomediastinal fistula presenting as purulent pericarditis in a healthy 32-year-old man.

Acute purulent pericarditis is rarely caused by anaerobic bacteria and it is almost always a complication of another disease process. Esophagomediastinal fistula, odontogenic, or pleuropulmonary infections have been reported to be the primary source of purulent pericarditis. If not diagnosed and treated promptly, purulent pericarditis is usually a fatal disease. We describe a case of bronchomediastinal fistula as sequels from a necrotizing parenchymal infection, leading on to secondary mediastinitis and pleuropericardial involvement in an immunocompetent patient. < is an important pathogen associated with a spectrum of intrathoracic suppurative infections. Purulent pericarditis can be fatal if not recognized early enough. Physicians should be aware of such a presentation.>.