Staphylococcus aureusによる感染性胸部大動脈瘤と化膿性心膜炎の1例

Infectious Thoracic Aortic Aneurysm and Purulent Pericarditis due to Staphylococcus aureus：Report of a Case

はじめに　感染性大動脈瘤と化膿性心膜炎はともに致死率の高いまれな疾患である．われわれは，根尖性歯周炎を侵入門戸とするmethicillin-­sensitive Staphylococcus aureus（MSSA）により，感染性胸部大動脈瘤と化膿性心膜炎をきたした症例を経験したので報告する．

The objective of this case report is to highlight a rare case of infectious thoracic aortic aneurysm and purulent pericarditis simultaneously in a 56-year-old woman. The patient complained of left anterior chest pain and contrast computed tomography （CT） revealed infectious thoracic aortic aneurysm and purulent pericarditis accompanied by massive pericardial effusion. She underwent a pericardial drainage immediately, and antibiotic treatment was initiated. Methicillin-sensitive Staphylococcus aureus was detected in blood and pericardial fluid cultures. On day eight of hospitalization, contrast CT scan showed enlargement of the aortic aneurysm. Therefore, total arch replacement was performed on day 10 using rifampicin-soaked graft. After surgery, antibiotic treatment was continued, till inflammatory markers became negative. She was discharged on day 66 without developing anastomotic pseudoaneurysms nor constrictive pericarditis.