Muay Thai Almost Drowned My Heart - A Case Report.

Rib fractures are frequently encountered in contact sports, with pyopneumothorax as a potentially severe complication. However, it is infrequent for pleural empyema to progress to purulent pericarditis and cardiac tamponade. In this report, we present a successful case of a 41-year-old previously healthy Muay Thai fighter who developed purulent pericarditis with cardiac tamponade due to the contiguous spread of infection from an empyemic hydropneumothorax caused by traumatic rib fracture. Emergency pericardial and pleural drainage were performed, and despite negative cultures from both pericardial and pleural fluid, empiric broad-spectrum antibiotic therapy demonstrated significant efficacy. This case highlights the importance of early recognition and treatment of infrequent but potentially lethal complications of rib fractures associated with contact sports.