Infected aortic aneurysm, purulent pericarditis, and pulmonary trunk rupture caused by methicillin-resistant Staphylococcus aureus.
A 66-year-old woman presented with cardiac tamponade. Pericardiocentesis revealed purulent pericarditis. Enhanced computed tomography showed a saccular aneurysm of the aortic arch. An irregularly shaped and partially enhanced mass was seen adjacent to the aneurysm, which suggested development of a mycotic pseudoaneurysm. Surgical drainage was performed through a subxiphoid incision, and continuous irrigation was commenced. On the following day, however, massive bleeding was recognized through the drains. The patient was immediately transferred to the operating theater, and extracorporeal circulation was established. A perforation 1 cm in diameter was found on the anterior surface of the pulmonary trunk, and a large amount of pus came out from the tear. The ascending aorta and the arch were found to be infected. Surgical repair was impossible due to extensive infection, and the patient died. Methicillin-resistant Staphylococcus aureus was isolated from the pericardial effusion, blood, and intraluminal thrombus of the aortic aneurysm.
Division of Cardiovascular Surgery, Aichi Cardiovascular and Respiratory Center, Ichinomiya, Aichi, Japan. shunei0110@ybb.ne.jp
Shunei
S
Saito
Akio
A
Matsuura
Ken
K
Miyahara
Haruki
H
Takemura
Sadanari
S
Sawaki
Hideki
H
Ito
D000368:Aged; D000785:Aneurysm, Infected / Q000382:microbiology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D010493:Pericarditis / Q000382:microbiology*; D011651:Pulmonary Artery / Q000382:microbiology*; D012422:Rupture, Spontaneous; D013203:Staphylococcal Infections / Q000150:complications* / Q000628:therapy