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Mycotic pseudoaneurysm of the aortic arch with purulent pericardial effusion
Michael J Ewing1, Philip D Houck, Glen B Drake
1Texas A&M HSC College of Medicine, Temple, Texas 76508, USA.
Abstract:
A 67-year-old woman presented with dyspnea on exertion and a diminished left radial pulse in comparison with the right. She had signs and symptoms of cardiac tamponade. A computed tomographic (CT) angiogram of the chest revealed an aortic arch pseudoaneurysm along the lesser curvature and a large pericardial effusion with the density of blood. Upon pericardiotomy, a nonhemorrhagic thick purulent effusion (Streptococcus milleri) was discovered in the pericardial space. Replacement of the aortic arch was performed with a rifampin-soaked Dacron tube graft, with the patient under hypothermic circulatory arrest.
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