The authors describe a 10-year-old boy with beta-thalassemia major who received double-unit unrelated cord blood transplantation and had a rocky post-transplantation course that included an episode of massive pericardial effusion. Pericardial tube drainage was performed for evacuating fluid. Results showed hemorrhagic pericardial effusion. A Staphylococcus aureus pericardial abscess eventually developed despite antibiotics coverage. Temporary drain placement was unsuccessful and the patient underwent radical pericardiectomy. Although cyclosporine therapy had to be stopped before the 6-month withdrawal, the patient did well with full donor chimerism 14 months post-transplant.
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