Cardiac tamponade: A rare presentation of pyogenic liver abscess as life threatening emergency

Pyogenic liver abscess is uncommon but a fatal condition. Cardiac tamponade is one of the potentially life-threatening complications of pyogenic liver abscess and is a medical emergency requiring immediate diagnosis and intervention. A 58-year-old male patient presented with fever, generalised weakness, cough with expectoration and gradually worsening dyspnoea and orthopnoea. Electrocardiogram revealed pericarditis; transthoracic echocardiogram revealed circumcardiac pericardial effusion with diastolic collapse of right ventricle indicating cardiac tamponade. Emergency pericardiocentesis was performed and pus-like pericardial fluid was drained. Liver abscess was diagnosed and managed surgically by laparoscopic drainage with placement of right intercostal and abdominal drain. Gradual decline in drain output was observed, drain was removed and patient was discharged in stable condition. This case emphasizes the timely intervention of procedures such as pericardiocentesis for cardiac tamponade and laparoscopic drainage for liver abscess which are lifesaving.