Why the study?
Pleural empyema rarely progresses to purulent pericarditis and cardiac tamponade following rib fractures in contact sports.
This case highlights the importance of early recognition and treatment of purulent pericarditis and cardiac tamponade as a rare but potentially lethal complication of traumatic rib fractures in contact sports.
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Alerts to tamponade risk after rib fractures in contact sports; single case leaves open optimal management strategies.
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.
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Pestrea et al. (2025) studied this question.
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