- Summary We present three cases of pericarditis caused by Streptococcus pneumoniae diagnosed in children. The presenting symptoms were fever, dyspnea, tachycardia, and hepatomegaly. Chest X-rays showed an enlarged heart silhouette and echocardiographic examination revealed a pericardial effusion in all cases. S. pneumoniae was recovered from the pericardial fluid and/or blood in all cases. Systemic antibiotic treatment and dopaminergic agents were used; all patients recovered completely. Another 10 cases of S. pneumoniae pericarditis in children reported since 1980 are presented. Most cases had preceding respiratory symptoms and had a good outcome. While rare and life-threatening, pericarditis caused by S. pneumoniae has a good outcome if diagnosed early and treated adequately.