# Aortic pseudoaneurysm as a rare complication of purulent pericarditis: case report and literature review

## TL;DR

A rare case of aortic pseudoaneurysm caused by purulent pericarditis is reported, highlighting the importance of early detection and treatment.

## Contribution

This case report adds to the limited literature on aortic pseudoaneurysm as a complication of purulent pericarditis.

## Key findings

- A 46-year-old man developed an aortic pseudoaneurysm following purulent pericarditis caused by MRSA.
- The patient was successfully treated with thoracic endovascular aortic repair and patch repair.
- The case underscores the need for prompt management of rare but life-threatening complications.

## Abstract

Purulent pericarditis has become rare in the antibiotic era, particularly when complicated by secondary infections such as an aortic pseudoaneurysm.

We report a 46-year-old man who presented with persistent chest pain and cold sweats for three days. Imaging revealed a large pericardial effusion, and cultures grew methicillin-resistant Staphylococcus aureus(MRSA). The patient underwent partial pericardiectomy with delayed sternal closure and open irrigation. On day 23, he developed right shoulder pain, and imaging revealed a pseudoaneurysm of the ascending aorta. Thoracic endovascular aortic repair combined with bovine pericardial patch repair was performed. He survived and remained stable during a 13-month outpatient follow-up.

Given the potential for fatal outcomes, clinicians should maintain a high index of suspicion and initiate prompt management, despite the rarity of this complication.