A case report of pyopneumopericardium following bungee jumping in a patient with tuberculosis.

Rationale: Pyopneumopericardium related to bungee jumping is a rare occurrence in the current antibiotic era. We present a case of esophagus-seeded Streptococcus sanguinis pyopneumopericardium in a young man with tuberculosis who had just completed bungee jumping.
Patient Concern: A 27-year-old man was hospitalized with a 1-day history of fever, chest tightness, and intermittent sharp chest pain after bungee jumping for the first time.
Diagnoses: Clinical examinations, thoracentesis, and pericardiocentesis revealed pyopneumopericardium, pyopneumomediastinum, and suppurative pleurisy secondary to bungee-jumping-related traumas. Pericardial fluid cultures were positive for S sanguinis, and Mycobacterium tuberculosis complex genetic test was positive in both sputum and pleural effusion.
Interventions: The patient improved with drainage and comprehensive antimicrobial therapy.
Outcomes: The patient developed constrictive pericarditis and underwent pericardiectomy after 6 months of anti-tuberculosis treatment. During the 6-month follow-up after surgery, he recovered uneventfully.
Lessons: This case adds to the long list of bungee-jumping complications. Early diagnosis to initiate appropriate therapy is critical for pyopneumopericardium patients to achieve good outcomes.