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Cardiac tamponade due to intrapericardial rupture of an amebic liver abscess

Tadamasa Miyauchi1, Hiroshi Takiya, Toshihiko Sawamura

  • 1Department of Cardiovascular Surgery, Gifu Prefectural Gifu Hospital, Gifu, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|May 7, 2005
PubMed

Insights

A rare case of amebic liver abscess ruptured into the pericardium, causing cardiac tamponade. Prompt surgical drainage and antibiotic treatment led to patient recovery.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Hepatology

Background:

  • Pericardial abscess is an uncommon condition, particularly when caused by amebic infection.
  • Amebic liver abscesses typically remain localized within the liver parenchyma.

Observation:

  • A 31-year-old male presented with fever, later developing epigastric pain and severe shortness of breath.
  • Imaging revealed an enlarged liver mass and significant pericardial effusion indicative of cardiac tamponade.
  • Emergency subxiphoid partial pericardiectomy drained 1000 ml of fluid, alleviating symptoms.

Findings:

  • Despite negative ameba cultures from pericardial fluid, a positive amebic serological test confirmed the etiology.
  • The patient's condition improved post-pericardiectomy and subsequent metronidazole treatment.

Implications:

  • This case highlights the potential for amebic liver abscesses to rupture into the pericardial space, leading to life-threatening cardiac tamponade.
  • Early diagnosis and combined surgical and medical management are crucial for favorable outcomes in such rare presentations.

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