**2.2 Infective**

Another etiology of pericardial effusions will include infectious causes. Even though rare in this day and age due to the use of antibiotics, infection of the pericardial space is a consideration in immunocompromised patients. These groups of patients can be rather septic from this deep-lying infection, especially if the source is bacterial in origin. In areas where tuberculosis is still prevalent, infection involving the pericardial cavity has been reported [2]. Treatment with the appropriate antibiotics can then be optimized when drainage has been achieved and the correct causative organism identified. The role of the surgeon here is to assist in surgical drainage for both therapeutic and diagnostic reasons. Occasionally, smaller bore drains inserted percutaneously are unable to reduce septic foci, and surgery is required for source control. However, unlike creating a permanent window for drainage into the pleural space in cases of malignant effusions, I would be less inclined to do so for infective causes. This is to avoid contaminating the pleural space with infection.
