Infection caused by meningococcal bacteria, typically affecting the brain, led to dangerous fluid buildup around the heart, causing cardiac tamponade requiring emergency surgery
Aster Hospital, Qusais, successfully performed a life-saving surgery on 52-year-old Indian expatriate Mr. Santiago Dias Rogue in an extraordinary and rare medical case. Mr. Rogue developed a bacterial infection that usually causes meningitis, but unusually, it triggered inflammation of the heart lining (pericarditis) and a dangerous fluid buildup, a life-threatening condition called cardiac tamponade.
Meningococcal infection usually affects the brain and its protective covering and rarely involves the heart. In this exceptionally rare case, Mr. Rogue had no involvement of the brain or its lining. Instead, he presented with an isolated infection of the sac surrounding the heart, which was complicated by a tense accumulation of fluid and pus, compressing the heart. Such a presentation is extremely uncommon, and the patient’s survival is a testament to the timely intervention, clinical expertise, and excellence in cardiac care demonstrated by the Aster Hospital, Qusais team. Aster Hospital, Qusais is recognized in Newsweek’s World’s Best Smart Hospitals 2025 list among 350 hospitals globally and ranked No. 14 on Newsweek’s World’s Best Hospitals in the UAE list.
Mr. Rogue, a married working professional and long-time resident of the UAE, came to the emergency department at Aster Hospital, Qusais, after experiencing upper stomach and chest pain for two days. Early tests pointed to a serious diabetes-related complication and a possible viral infection around the heart. His long-standing, uncontrolled diabetes made his condition more complicated. He also reported painful swelling in his wrist joint, which was later identified as reactive arthritis associated with the underlying infection.
Soon the patient’s condition deteriorated and he became unstable. Urgent Echocardiography revealed that the heart was severely compressed all around by tense fluid collection in its sac, a condition called cardiac tamponade which is a surgical emergency.
The complex procedure was performed by a team led by Dr. Sandeep Shrivastava and Dr. Shipra Shrivastava, Consultant Cardiothoracic Surgeons, supported with quick timely diagnosis and appropriate medical management. The prompt diagnosis by Dr. Krishna Sarin MS Nair, Interventional Cardiologist at Aster Hospital, Qusais raised alarm regarding the quick transfer of the patient to the operating room.
Commenting on the complexity and urgency of Mr. Rogue’s condition, Dr. Sandeep Shrivastava, Consultant Cardiothoracic Surgeon at Aster Hospital, Qusais, said, “This was a very rare and complicated case, where a serious bacterial infection affected the outer lining of the patient’s heart. His uncontrolled diabetes and the sudden buildup of fluid around the heart made the situation even more critical and challenging. Early diagnosis, quick action and teamwork were key to saving his life. We performed emergency surgery to open the chest, drain the infected fluid, remove the infected material and thus relieve pressure around the heart so that his heart could function normally again.”
Dr. Krishna Sarin MS Nair, Interventional Cardiologist, Aster Hospital, Qusais, said “Early diagnosis is critical for appropriate management of a rare, severe bacterial infection like this. Not only were we able to prevent an acute collapse by timely diagnosis and surgery, also we were able to avoid the bad scarring that occurs around the heart once these kind of infections heal.”
“His heart function stabilized post-surgery, and he responded remarkably well to treatment. Given the highly contagious and airborne nature of meningococcal bacteria, strict isolation protocols were followed to safeguard the team and the contact personnel susceptible to acquiring the deadly infection.,” added Dr. Shipra Shrivastava, Consultant Cardiothoracic Surgeon at Aster Hospital, Qusais. She also emphasized that ensuring the safety of other hospital in-patients was a top priority and was handled efficiently.
The 2-hour high-risk procedure involved navigating multiple clinical challenges, including the patient’s unstable condition, infectious risk to the surgical team, and rapid relief of the fluid compressing the heart to save patient’s life.
Following three days in the ICU, Mr. Rogue was shifted to the ward, where he completed a full course of two weeks of intravenous antibiotics as per the sensitivity report and guideline protocol. He was discharged in excellent condition.
Expressing deep gratitude and surprise at the severity of his condition, Mr. Santiago Dias Rogue said, “I can’t thank the doctors and staff at Aster Hospital enough. I never imagined I had a life-threatening infection. Their timely action saved my life. I’m especially grateful to Dr. Sandeep, Dr. Shipra, and Dr. Krishna for their skill and compassion.”
Meningococcal disease is a rare but serious bacterial infection that usually causes meningitis. In this case, however, the infection involved the pericardium (the outer lining of the heart), one of the rarest forms of meningococcal disease known as Primary Meningococcal Pericarditis (PMP). Based on medical literature, this appears to be one of the rarest and hardly reported cases of meningococcal infection primarily affecting the heart and leading to cardiac tamponade. Only six other cases have been reported worldwide. Although approximately 2 in every 10,000 people may develop cardiac tamponade from other underlying diseases, the likelihood of it occurring specifically due to a meningococcal infection is hardly reported, highlighting the exceptional rarity of Mr. Rogue’s case and the importance of clinical awareness, early diagnosis, and swift multidisciplinary medical and surgical intervention.
In Mr. Rogue’s case, doctors performed an emergency procedure to create two generous openings in the covering around the heart, pericardium, to drain the fluid freely and prevent it from building up again. This crucial step relieved the pressure on his heart, restoring it’s normal function and ultimately saving his life.
Aster Hospital, Qusais’s Center of Excellence for Cardiac Sciences demonstrates the exceptional expertise required to manage this exceptionally rare form of meningococcal pericarditis leading to cardiac tamponade, showcasing the team’s excellence in Cardiac Care and saving Mr. Rogue’s life.
Suggested Reading: Aster DM Healthcare & GEMS Education Launch Health & Wellness Drive
