Infectious pseudo-aneurysm of the left ventricle: a case report and a review of the literature

• Main Authors: Amadu E. Juliana, Kevin H. van ’t Kruys, Pieter G. Voigt, Nico A. Blom
• Format: Article
• Language: English
• Published: BMC 2020-03-01
• Series: BMC Cardiovascular Disorders
• Subjects: Purulent pericarditis; Pseudo-aneurysm; Left ventricle; Children; Suriname
• Online Access: http://link.springer.com/article/10.1186/s12872-019-01299-x

Abstract Background In the workup of a pediatric patient with pericarditis we found evidence of a pseudo-aneurysm of the left ventricle, which is a rare complication of purulent pericarditis. Case presentation We present a case of a six-year-old girl who was diagnosed with pericarditis and a fistula between the pericardial and the intra-luminal space of the left ventricle of the heart. She was successfully treated with antibiotics and cardio-thoracic surgery. We found 23 published cases (21 with follow-up) of infectious pseudo-aneurysm of the heart, of which 19 underwent surgery, 5 had fatal outcome, and 2 who refused surgery survived. The majority of cases were associated with Staphylococcus aureus. The exact mechanisms of this rare complication remain unknown. Conclusions A pseudo-aneurysm of the left ventricle is a rare and not well understood complication of a purulent pericarditis most commonly caused by Staphylococcus aureus infection. Because of risk of rupture, surgical intervention is advised.