Purulent pericarditis is a localized infection of the pericardium producing an effusion that is both microscopically and macroscopically purulent. Purulent pericarditis is most frequently caused by Staphylococcus, although rarely Streptococcus and other organisms are implicated. This article describes a case of invasive group A streptococcal disease presenting as purulent pericarditis with multiple splenic abscesses in a 4-year-old boy.