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Published on: November 29, 2018
Streptococcus pyogenes Pericarditis with Resultant Pulmonary Trunk Compression Secondary to Mycotic Pseudoaneurysm
E Fry1, J Urbanczyk1, J Price1
1Baylor Scott and White Medical Center, Temple, TX, USA.
Abstract:
Purulent pericarditis is a rare disease in the era of antibiotics, with Streptococcus pyogenes being a possible, though uncommon etiology. Even more uncommon are mycotic aneurysms secondary to group A strep purulent pericarditis and bacteremia. We report a case of an 18-year-old female with a history of strep pharyngitis develop Streptococcus pyogenes purulent pericarditis with subsequent ventricular fibrillation (VF). Following initial stabilization, she ultimately developed a 4.8 cm mycotic aneurysm of the ascending aorta, with resultant compression of the pulmonary trunk and right pulmonary arteries.
Insights
A rare case of purulent pericarditis caused by Streptococcus pyogenes in an 18-year-old female led to ventricular fibrillation and a large mycotic aneurysm. This highlights the potential for severe cardiovascular complications from group A strep infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Case Reports
Background:
- Purulent pericarditis is a rare condition, especially in the antibiotic era.
- Streptococcus pyogenes (group A Streptococcus) is an uncommon cause of purulent pericarditis.
- Mycotic aneurysms are infrequent complications of group A strep infections.
Observation:
- An 18-year-old female presented with purulent pericarditis following strep pharyngitis.
- The patient experienced ventricular fibrillation (VF) secondary to the infection.
- A large (4.8 cm) mycotic aneurysm of the ascending aorta developed post-stabilization.
Findings:
- The mycotic aneurysm caused significant compression of the pulmonary trunk and right pulmonary arteries.
- This case demonstrates a rare but severe progression of Streptococcus pyogenes infection.
- The combination of purulent pericarditis, bacteremia, and subsequent mycotic aneurysm is exceptionally uncommon.
Implications:
- This case underscores the importance of considering rare complications of common infections.
- Early recognition and management of Streptococcus pyogenes infections are crucial to prevent severe cardiovascular sequelae.
- Further research may be needed to understand the pathogenesis of mycotic aneurysm formation in this context.
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