Pyopericardium progressing to cardiac tamponade in a patient with dengue fever

Pyopericardium is a rare cause of cardiac tamponade. We present a case of a dengue fever patient who presented with cellulitis of the upper limbs, later manifesting cardiac tamponade, which was fatal. Although echocardiography on admission revealed a small pericardial effusion only, it later manifested as tamponade, causing cardiogenic shock. Staphylococcus pyopericardium was found later. Early identification could be possible with bedside point-of-care ultrasonography and echocardiography. Emergent pericardiocentesis or pig tail drain placement is life saving. •Dengue is an important public health problem.•It may present with mild symptoms or severe form of dengue hemorrhagic fever.•Cardiac tamponade patients are usually anxious, with dyspnea and chest pain.•Early identification is possible with bedside ultrasonography.•Emergent pericardiocentesis or pig tail drain placement is life saving.