Korean J Med.  2013 Jun;84(6):842-846.

A Case of Pyogenic Liver Abscess Complicating Cardiac Tamponade Caused by Klebsiella pneumoniae

• Choi EY
• Ha SJ
• Lee JH
• Jang WS
• Kim JB
• Kim W
• Kim WS

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.

Keyword

Pyogenic pericarditis; Cardiac tamponade; Liver abscess, pyogenic; Klebsiella pneumoniae

MeSH Terms

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