Primary meningococcal pericarditis presenting with tamponade.

An unusual case of a patient with primary meningococcal pericarditis presenting with tamponade is reported. tdespite repeated aspiration and appropriate antibiotic therapy with eradication of group C Neisseria meningitidis, pericardial effusion continued to reaccumulate. Institution of high-dosage corticosteroid therapy resulted in rapid resolution of the effusion. Only six other cases of primary meningococcal pericarditis have been reported in the English literature. Early manifestations of this disease are due to bacterial invasion of the pericardium. The later phase of intensive reaccumulation of sterile pericardial fluid may conceivably be related to meningococcal endotoxin and appears to be responsive to corticosteroid or salicylate therapy. Recognition of this phenomenon may obviate the necessity for a pericardiectomy.