Intravenous fluid administration is a vital compo nent in the resuscitation of critically ill patients [1]. Previously the clinical practice guiding the choice of fluid used in resuscitation has been predominantly governed by the opinion of the treating physician [2]. However, over the past decade there have been a va riety of publications on this matter that can assist in guiding the treating physician [3][4][5][6]. In 2012, two landmark studies were published against the use of hydroxyethyl starches (HES) [3,4]. The 6s study group found that when comparing resuscitation using HES versus resuscitation using acetated Rin gers in patients with severe sepsis, those who were resuscitated with HES had an increased risk of death and were more likely to require renal replacement therapy [3]. Similarly, the CHEST study group found that when comparing HES use versus saline in inten sive care patients, those resuscitated with HES were more likely to require renal replacement therapy [4].

Purulent pericardial effusions are rare and represent the most severe form of bacterial pericarditis. The authors present a case of a male in his 40s with a massive purulent pericardial effusion due to non-typhoid Salmonella, who presented with ultrasound features of a cardiac tamponade. Invasive non-typhoid Salmonella cardiac infection is a rare but important consideration in immunocompromised individuals. This of particular concern in sub-Saharan Africa, where there is a high prevalence of HIV-infected individuals.