Coxsackie B viral infection presenting with hemorrhagic pericardial effusion and pleural effusion

We report an 11-year-old female child presenting with hemorrhagic pericardial effusion causing cardiac tamponade along with moderate left ventricular dysfunction, who screened positive for Coxsackie B infection in the setting of cough, shortness of breath, and chest pain. She needed emergency pericardiocentesis. She also had massive bilateral hemorrhagic pleural effusions requiring bilateral chest drains placement. With a presumed diagnosis of acute myopericarditis, she was treated with steroids and ibuprofen. She made a full recovery without any further recurrence of pericardial or pleural effusion.