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A rare case of massive pericardial effusion due to spontaneous rupture of Streptococcus anginosus group liver abscess

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Abstract

Purulent pericardial effusion is a rare and life-threatening complication of pyogenic liver abscess if not diagnosed and intervened early. Due to its nonspecific presentation, diagnosis of pyogenic liver abscess is challenging. Herein, we discuss the case of a 31-year-old healthy male that presented with acute chest tightness for one day in the setting of spontaneous rupture of pyogenic liver abscess and developed transdiaphragmatic extension of purulent pericardial effusion. The abscess resolved with antibiotic therapy (beta-lactam), ultrasound-guided aspiration, and pericardial window. Culture of pericardial fluid yielded the Streptococcus anginosus group. He was subsequently discharged following clinical resolution and normalization of liver function tests after 15 days of treatment. Follow-up ultrasonography revealed that the liver abscess and pericardial effusion were resolved in 8 weeks post treatment and intervention.

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Authors and Affiliations

  1. Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand

    Tanaporn Prateepchaiboon

  2. Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, 90110, Thailand

    Keerati Akarapatima, Attapon Rattanasupa & Arunchai Chang

  3. Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Hatyai Hospital, Songkhla, Thailand

    Warut Pisudtinontakul

Authors
  1. Tanaporn Prateepchaiboon
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  2. Keerati Akarapatima
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  3. Warut Pisudtinontakul
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  4. Attapon Rattanasupa
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  5. Arunchai Chang
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Contributions

Conception and design: TP, AC; review and data collection: TP, KA, WP, AR; draft of the article, provision of table and figures: TP, KA, WP; study supervision and final approval of the version: AC; all authors contributed important intellectual content and approved the final version of the manuscript.

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Correspondence to Arunchai Chang.

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Drs. Tanaporn Prateepchaiboon, Keerati Akarapatima, Warut Pisudtinontakul, Attapon Rattanasupa, and Arunchai Chang have no conflicts of interest or financial ties to disclose.

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Prateepchaiboon, T., Akarapatima, K., Pisudtinontakul, W. et al. A rare case of massive pericardial effusion due to spontaneous rupture of Streptococcus anginosus group liver abscess. Clin J Gastroenterol 13, 1258–1264 (2020). https://doi.org/10.1007/s12328-020-01196-3

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  • DOI: https://doi.org/10.1007/s12328-020-01196-3

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