Purulent pericarditis in the antibiotic era has become an uncommon entity. It is typically an acute illness with a high mortality (about 30%) related to cardiac tamponade, a complication that accounts for 42-77% of cases. Few cases of purulent pericarditis associated with tamponade have been published in the literature. In this paper we describe a complicated case of purulent pericarditis secondary to left pneumonia. In particular, we emphasize the importance of early recognition, prompt institution of appropriate antibiotic therapy and early drainage for survival.