Case report of an unusual combination of purulent pericarditis and false aneurysm of the ascending aorta

Abstract

Background: Purulent pericarditis is an uncommon entity, which is, in very rare cases, associated to infection of the aorta.

Purulent bacterial pericarditis from Staphylococcus aureus

“…Purulent pericarditis is a rare, life‐threatening infection of the pericardial space that may initially elude diagnosis. Purulent pericarditis was more prevalent in the pre‐antibiotic era and was a feared complication of pneumococcal pneumonia . Although purulent pericarditis occurs in only an estimated 1 of 18 000 hospitalized patients, the progression can be very rapid, and half of all cases are diagnosed on autopsy .…”

“…Aside from pulmonary parenchymal disease, purulent pericarditis is associated with other infections of the mediastinum and neck, such as empyema, mediastinitis from dental infection, intracardiac medical devices, eroding intrathoracic malignancies, and endocarditis and bacteremia . The microbiology of purulent pericarditis reflects this, with Staphylococcus , Streptococcus , Haemophilus , and Mycobacterium tuberculosis predominating, though atypical organisms such as Candida and Salmonella have been described.…”

An Unusual Complication of Pericarditis

“…Substantial left/right shunting developed, leading to right heart decompensation with tricuspid regurgitation and liver congestion. Thus, it can be concluded that in case of high-risk pathogens such as Staphylococcus spp., clinicians should be aware that serious complications such as mycotic aneurysms 6 or even fistulas creating a hemodynamically relevant shunt may lead to life-threatening situations within a few days.…”