Aortic Pseudoaneurysm as a Rare Complication of Purulent Pericarditis: Case Report and Literature Review

Background: Purulent pericarditis has become rare in the antibiotic era, particularly when complicated by secondary infections such as aortic pseudoaneurysm. Case Presentation: We report the case of a 46-year-old man presenting with persistent chest pain and cold sweating for three days. Imaging revealed a large pericardial effusion, and cultures identified methicillin-resistant Staphylococcus aureus (MRSA). The patient underwent partial pericardiectomy with open irrigation. On day 23, he developed right shoulder pain, and imaging revealed a pseudoaneurysm of the ascending aorta. Thoracic endovascular aortic repair (TEVAR) with bovine pericardial patch repair was performed. He survived and remained stable during a 13-month outpatient follow-up. Conclusion: Given the potential for lethal outcomes, we strongly recommend a high level of suspicion and prompt management, albeit exceedingly rare.