BMC Cardiovasc Disord. 2025 Nov 24;25(1):830. doi: 10.1186/s12872-025-05332-0.

ABSTRACT

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

CASE PRESENTATION: 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.

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

PMID:41286644 | PMC:PMC12642142 | DOI:10.1186/s12872-025-05332-0