title: Cardiac tamponade due to intrapericardial rupture of an amebic liver abscess.
abstract: Pericardial abscess is rare in healthy individuals, especially the amebic type. We report a case of pericardial abscess and cardiac tamponade due to intrapericardial rupture of an amebic liver abscess. A 31-year old Japanese male complained of fever to a local hospital. A liver mass was discovered in his left hepatic lobe by an abdominal echogram. He was referred to the internal department of our hospital and was treated with quinolone antibiotics. Two weeks after medication, he suddenly complained of epigastralgia and severe orthopnea and was admitted. Abdominal computed tomographic scan showed an enlarged liver mass, and massive pericardial effusion suggested cardiac tamponade. He underwent an emergency subxiphoid partial pericardiectomy under local anesthesia. 1,000 ml of light brownish fluid was removed and his condition improved. Although no ameba was cultivated from the pus, the amebic serological test was positive. Metronidazole was administered and the patient was discharged 31 days after surgery.
authors.affiliation: Department of Cardiovascular Surgery, Gifu Prefectural Gifu Hospital, Gifu, Japan.
authors.forename: Tadamasa
authors.initials: T
authors.lastname: Miyauchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takiya
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sawamura
authors.forename: Eiji
authors.initials: E
authors.lastname: Murakami
mesh_terms: D000328:Adult; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures; D003937:Diagnosis, Differential; D005334:Fever / Q000209:etiology; D006801:Humans; D008101:Liver Abscess, Amebic / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D008795:Metronidazole