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Pericardial effusions in bacterial meningitis are not common.

We read with interest the paper entitled "The Frequency of Pericardial Effusions in Bacterial Meningitis" by Laird and colleagues (Pediatrics 63:764-770, 1979). In our view, the authors' conclusions that "pericardial infection is common in patients with meningitis, but that it is usually of no clinical significance and resolves with antibiotic therapy" are unjustified from the evidence presented. It is well recognized that echocardiography is a sensitive method for detecting the presence of a pericardial effusion, but unfortunately, there are no echocardiographic features which define the etiology of the effusion.