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Cardiac tamponade due to perforation of a Roseomonas mucosa pyogenic hepatic abscess as initial presentation of hepatoid carcinoma
  1. Jeffrey Spindel1,
  2. Mladen Grigorov1,
  3. Molly Baker2 and
  4. Luis Marsano3
  1. 1Internal Medicine, University of Louisville, Louisville, Kentucky, USA
  2. 2Internal Medicine and Pediatrics, University of Louisville, Louisville, Kentucky, USA
  3. 3Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Dr Jeffrey Spindel; jeffrey.spindel{at}


Hepatic abscesses can rarely cause pericardial disease by erosion into the pericardial space and present with haemodynamic instability due cardiac tamponade. While rare, these dramatic presentations are more often due to amoebic abscesses than bacterial abscesses. Importantly, a cause must be found for any cryptogenic hepatic abscess regardless of presentation, as there is a high association with underlying malignancy. We report a previously healthy man in his 30s who presented with cardiac tamponade from perforation of a Roseomonas mucosa pyogenic hepatic abscess into the pericardium in the absence of bacteremia and biliary disease. One year later, he was found to have diffusely metastatic hepatoid carcinoma.

  • pericardial disease
  • infection (gastroenterology)
  • hepatitis and other GI infections
  • oesophageal cancer
  • pathology

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  • Contributors Case conceptualisation and design: JS and LM. Data collection and writing of draft: JS, MG and MB. Analysis and Interpretation of results and revision of manuscript: All authors. Review of literature: JS and MG. Oversight: LM. All authors have seen and approved of the final submitted manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.