title: Mycotic pseudoaneurysm of the aortic arch with purulent pericardial effusion.
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.
authors.affiliation: Texas A&M HSC College of Medicine, Temple, Texas 76508, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ewing
authors.forename: Philip D
authors.initials: PD
authors.lastname: Houck
authors.forename: Glen B
authors.initials: GB
authors.lastname: Drake
authors.forename: Kenton J
authors.initials: KJ
authors.lastname: Zehr
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000382:microbiology / Q000601:surgery*; D001013:Aorta, Thoracic; D001019:Aortic Rupture / Q000382:microbiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D010490:Pericardial Effusion / Q000382:microbiology / Q000601:surgery*; D013290:Streptococcal Infections / Q000150:complications* / Q000382:microbiology; D034364:Streptococcus milleri Group / Q000302:isolation & purification*; D013492:Suppuration