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Mycotic pseudoaneurysm of the thoracic aorta with purulent pericarditis
K R Shroyer1, G S Svedlow, D M Adcock
1Department of Pathology, University of Colorado Health Sciences Center, Denver 80262.
Abstract:
Mycotic pseudoaneurysms are vascular lesions composed of laminated clot and fibrous tissue and containing bacterial microorganisms. The case reported here it the third in the English literature to describe the association of purulent pericarditis with rupture of a mycotic aortic aneurysm. A 65-year-old male developed cardiac tamponade secondary to Staph. aureus pericarditis. Following a surgical procedure to drain the pericardial sac, the postoperative course was complicated by fatal hemorrhage from a ruptured thoracic pseudoaneurysm. Postmortem examination indicated that the aortic pseudoaneurysm originated at the site of an ulcerated atherosclerotic plaque. A Staph. aureus infection of the aortic lesion, with erosion into the pericardial space, was the apparent cause of purulent pericarditis.
Insights
This case report details a fatal mycotic aortic aneurysm rupture in a patient with Staph. aureus pericarditis. It highlights the rare association between purulent pericarditis and mycotic aneurysms.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Pathology
Background:
- Mycotic pseudoaneurysms are vascular lesions with bacterial microorganisms.
- Purulent pericarditis is inflammation of the pericardium with pus formation.
Observation:
- A 65-year-old male presented with cardiac tamponade due to Staphylococcus aureus pericarditis.
- He developed fatal hemorrhage from a ruptured thoracic pseudoaneurysm post-pericardial drainage.
Findings:
- The aortic pseudoaneurysm originated from an ulcerated atherosclerotic plaque.
- Staphylococcus aureus infection of the plaque led to pericarditis and aneurysm rupture.
Implications:
- This case underscores the critical link between infected aortic aneurysms and purulent pericarditis.
- Early recognition and treatment of mycotic aneurysms are vital to prevent catastrophic outcomes.