Constrictive pericarditis complicating a case of staphylococcal pyomyositis - A rare presentation in immunocompetent patient

Tropical pyomyositis is a subacute, deep, suppurative infection of muscles and soft tissue region affecting predominantly immunocompetent young males. Atypical presentation with other system involvement is seen in immunocompromised patients, rarely in healthy adults. The incidence of cardiovascular complications has been reported in a few case reports only. We present here a case of 14 year old boy presenting with constrictive pericarditis as a direct result of pyomyositis. Cardiac MRI revealed pericardial thickening with a thick loculated collection along the right atrium and right ventricle chambers suggestive of early constrictive pericarditis. The pus aspirated from the abscess tested positive for Staphylococcus aureus. Patient was treated intensively with parenteral antibiotics and the abscess was drained surgically. We highlight the importance of timely diagnosis of the condition to prevent development of serious sequelae, thereby reducing associated morbidity and mortality.