Pyopericardium with cardiac tamponade caused by pyogenic liver abscess: a case report

J Med Case Rep. 2025 Jan 8;19(1):7. doi: 10.1186/s13256-024-05014-z.

Abstract

Introduction: Purulent bacterial pericarditis is a potentially fatal disease with mortality rates reaching 100% if left untreated.

Case presentation: We present the case of a 33-year-old Caucasian male patient who developed cardiac tamponade, most likely caused by a pyogenic liver abscess communicating with the pericardium. Treatment with antibiotics, extended sepsis therapy, and drainage of the abscess led to a full recovery.

Conclusion: This report describes a rare but potentially fatal differential diagnosis of aortic dissection and serves as a reminder that lives abscesses can manifest unexpectedly. Clinical signs and symptoms of tamponade can be mistaken as sepsis. In this particular case, the combination of a septic abscess and tamponade caused by pyopericardium posed a diagnostic challenge.

Keywords: Cardiac tamponade; Case report; Pyogenic liver abscess; Pyopericardium.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / therapeutic use
  • Cardiac Tamponade* / etiology
  • Diagnosis, Differential
  • Drainage
  • Humans
  • Liver Abscess, Pyogenic* / complications
  • Liver Abscess, Pyogenic* / diagnosis
  • Liver Abscess, Pyogenic* / microbiology
  • Male
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / etiology
  • Pericardial Effusion / microbiology
  • Pericarditis / complications
  • Pericarditis / diagnosis
  • Pericarditis / microbiology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents