A 39-year-old man was admitted for upper abdominal pain and shortness of breath. 
The chest roentgenogram demonstrated cardiomegaly and left lower lobe 
atelectasis. Echocardiography showed circumferential pericardial effusion with 
signs of cardiac tamponade. Pericardial biopsy and fluid analysis were 
consistent with fibrino-purulent pericarditis. Despite broad-spectrum 
antibiotics, percutaneous and subsequently surgical drainage, pericardial 
effusion and tamponade recurred. We report successful treatment of a 
non-resolving fibrino-purulent pericardial effusion by combined intrapericardial 
irrigation of fibrinolytics and systemic corticosteroids administration as an 
alternative to pericardectomy.