Purulent MRSA Pericarditis Secondary to Chronic Diabetic Foot Osteomyelitis: A Case Report.

Purulent pericardial effusion is a rare but life-threatening manifestation of bacterial infection, most commonly caused by Staphylococcus aureus bacteremia. We report the case of an 86-year-old female with chronic diabetic foot osteomyelitis complicated by persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. The patient subsequently developed purulent pericarditis, bilateral exudative pleural effusions, septic shock, and acute renal failure requiring continuous renal replacement therapy (CRRT) after intolerance to intermittent hemodialysis due to refractory hypotension. Despite broad-spectrum antimicrobial therapy and drainage of infected compartments, the patient developed refractory multiorgan failure and expired on hospital Day 26. This case highlights the high mortality associated with purulent pericarditis in the setting of persistent bacteremia and delayed source control.