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Case Reports
. 2018 Aug 16:2018:3514797.
doi: 10.1155/2018/3514797. eCollection 2018.

Streptococcus pyogenes Pericarditis with Resultant Pulmonary Trunk Compression Secondary to Mycotic Pseudoaneurysm

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Case Reports

Streptococcus pyogenes Pericarditis with Resultant Pulmonary Trunk Compression Secondary to Mycotic Pseudoaneurysm

E Fry et al. Case Rep Cardiol. .

Abstract

Purulent pericarditis is a rare disease in the era of antibiotics, with Streptococcus pyogenes being a possible, though uncommon etiology. Even more uncommon are mycotic aneurysms secondary to group A strep purulent pericarditis and bacteremia. We report a case of an 18-year-old female with a history of strep pharyngitis develop Streptococcus pyogenes purulent pericarditis with subsequent ventricular fibrillation (VF). Following initial stabilization, she ultimately developed a 4.8 cm mycotic aneurysm of the ascending aorta, with resultant compression of the pulmonary trunk and right pulmonary arteries.

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Figures

Figure 1
Figure 1
Significant ECGs. (a) Diffuse ST elevation and PR depressions indicating pericarditis. (b) S1Q3T3 phenomenon.
Figure 2
Figure 2
Transthoracic 2D echocardiography images. Echo images concerning for compression of the pulmonary vasculature.
Figure 3
Figure 3
CT scans identifying pseudoaneurysm. Pseudoaneurysm compressing on the pulmonary trunk and right main stem (a) and 4.8 cm aortic pseudoaneurysm (b).
Figure 4
Figure 4
Intraoperative transesophageal echocardiogram. D-shaped ventricle indicating right heart strain seen in multiple frames.

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