A Case of Pyogenic Liver Abscess Complicating Cardiac Tamponade Caused by Klebsiella pneumoniae.
- Author:
Eun Yong CHOI
1
;
Sang Jin HA
;
Jung Hoon LEE
;
Won Seok JANG
;
Jin Bae KIM
;
Weon KIM
;
Woo Shik KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea. hippoha71@hanmail.net
- Publication Type:Case Report
- Keywords:
Pyogenic pericarditis;
Cardiac tamponade;
Liver abscess, pyogenic;
Klebsiella pneumoniae
- MeSH:
Abdominal Pain;
Abscess;
Bile;
Cardiac Tamponade;
Drainage;
Dyspnea;
Echocardiography;
Emergencies;
Female;
Fistula;
Hemodynamics;
Humans;
Klebsiella;
Klebsiella pneumoniae;
Korea;
Liver Abscess;
Liver Abscess, Pyogenic;
Pericardial Effusion;
Pericardium
- From:Korean Journal of Medicine
2013;84(6):842-846
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
An 83-year-old female patient visited the emergency department for abdominal pain and dyspnea with hemodynamic instability. Abdominal computed tomography showed multiple liver abscesses and a large volume of pericardial effusion. A transthoracic echocardiography revealed features suggestive of cardiac tamponade, including massive pericardial effusion and diastolic collapse of the right atrial wall. Emergency percutaneous pericardial drainage and percutaneous transhepatic drainage were performed. Klebsiella pneumoniae (KP) was isolated from both the pericardial effusion and bile. The first case of cardiac tamponade secondary to a liver abscess in Korea was reported in 1981, and it was caused by amoebal infection via fistula formation between the pericardium and abscess. We recently experienced a case of pyogenic liver abscess caused by KP complicating cardiac tamponade via direct invasion. This is an unusual complication of KP infection because KP is more frequently associated with hematogenous spread.
