Purulent pericarditis due to co-infection with Streptococcus pneumoniae and Mycobacterium tuberculosisin a patient with features of advanced HIV infection

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Abstract
Both Mycobacterium tuberculosis and Streptococcus pneumoniae are common pathogens in patients with HIV infection. We present an unusual case of purulent pericarditis resulting in cardiac tamponade due to infection with both organisms. We highlight the re-emergence of pneumococcal pericarditis in the HIV era and describe the pitfalls and challenges in the diagnosis of this condition. Clinicians working in HIV endemic areas need to consider dual infection with these organisms in patients who respond inadequately to either antibiotics or anti-tuberculous therapy alone.