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A 23-day-old baby was admitted with a diagnosis of septic arthritis of his right shoulder (positive joint aspirate of Streptococcus pneumonia). After 2 days of antibiotic treatment he was noted to be oedematous, tachypnoeic and tachycardic and a cardiac opinion was sought. Echocardiogram (fig 1) suggested a dense collection surrounding the heart suggestive of fibrinous effusion or a mass. Computerised tomography (CT) instead of magnetic …
Competing interests: None.