Liver abscess caused by Bacteroides thetaiotaomicron complicated by purulent pericarditis: a case report.

BACKGROUND

Liver abscess complicated by purulent pericarditis is a rare clinical condition. To date, no cases of liver abscess caused by Bacteroides thetaiotaomicron with concomitant purulent pericarditis have been reported. We present a rare case of this dual pathology to improve clinicians' understanding of liver abscess-related complications and uncommon pathogens.

CASE PRESENTATION: A 33-year-old female was admitted with hypothermia, chest tightness, and vomiting. Upon admission, laboratory tests showed elevated inflammatory markers. Ultrasound imaging revealed both pericardial effusion and a hepatic abscess, leading to a diagnosis of liver abscess complicated by purulent pericarditis. Metagenomic next-generation sequencing (mNGS) of pericardial fluid identified Bacteroides thetaiotaomicron. The patient received anti-infective therapy with meropenem and ornidazole, combined with pericardial effusion drainage. During the later stage of treatment, the patient developed thoracic empyema, necessitating thoracic drainage. Following treatment, the inflammatory markers significantly improved, the liver abscess reduced in size, and the pericardial effusion nearly resolved. At the 8-week follow-up after discharge, clinical and imaging findings were normal.

CONCLUSION

This case highlights the importance of recognizing atypical manifestations in immunocompromised patients and emphasizes the critical role of early comprehensive examination, prompt and effective anti-infective therapy, and puncture drainage for improving patient outcome. Pathogen identification methods such as mNGS can guide more precise treatment strategies, thereby shortening hospitalization and reducing complications.