What is the clinical evidence from this study?

Study design: Case Report. Population: Mycotic coronary aneurysm with purulent pericarditis (n=1). Intervention: Urgent pericardial drainage and surgical repair. Primary outcome: Clinical outcome.

What does this research mean for the field?

Mycotic coronary aneurysms can rapidly dilate and rupture into the pericardial cavity, presenting as purulent bloody pericarditis that requires prompt multimodal imaging and timely surgical intervention. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To highlight the clinical presentation and challenges in diagnosing a mycotic coronary aneurysm associated with purulent pericarditis.

June 7, 2026European Heart Journal - Case ReportsOpen Access

A case with suspected ruptured mycotic coronary aneurysm presenting as purulent bloody pericarditis

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Key result

Ruptured mycotic coronary aneurysm from persistent S. aureus bacteremia proves fatal despite urgent surgical repair.

Why the study?

Coronary artery aneurysms are rare, and mycotic coronary aneurysms arising secondary to bacterial infection are even rarer.

Population

A 77-year-old woman with end-stage renal disease

Design

Case report

Authors

KKKoji KashikiTambov State Technical University KMKensuke MatsumotoTambov State Technical University AYAkitoshi YamadaTokyo-Kita Medical Center

Discussion

Member takes

Implication

Fatal rupture can occur rapidly despite intervention in S. aureus bacteremia with purulent pericarditis; leaves open optimal prevention and management strategies.

Key Points

To highlight the clinical presentation and challenges in diagnosing a mycotic coronary aneurysm associated with purulent pericarditis.
Case report of a 77-year-old woman with end-stage renal disease presenting with fever and pericardial effusion.
Diagnosis was supported by echocardiographic findings and blood culture results confirming methicillin-sensitive Staphylococcus aureus.
Timely interventions included pericardial drainage and plans for surgical repair.
A well-demarcated hypoechoic lesion encasing the right coronary artery was identified.
Purulent bloody pericardial fluid was evacuated, with S. aureus isolated from the fluid.
The aneurysm ruptured before planned surgery, leading to patient death.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 77-year-old woman with end-stage renal disease who developed a ruptured mycotic coronary aneurysm and purulent pericarditis following arteriovenous fistula creation.

Exposure

Urgent pericardial drainage and surgical repair

Outcome

Clinical outcome (survival/death)hard clinical

Mycotic coronary aneurysms can present as purulent bloody pericarditis and require a high index of suspicion and prompt surgical intervention due to the high risk of rapid dilation and rupture.

Cite This Study

Kashiki et al. (2026) conducted a case report in Mycotic coronary aneurysm with purulent pericarditis (n=1). Urgent pericardial drainage and surgical repair was evaluated on Clinical outcome. A 77-year-old woman with persistent Staphylococcus aureus bacteremia developed a ruptured mycotic coronary aneurysm and purulent pericarditis, ultimately dying after surgical repair.

synapsesocial.com/papers/6a250ce97def13d035e1d193 https://doi.org/10.1093/ehjcr/ytag410

Topics

Pericardial disease

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Implication

Fatal rupture can occur rapidly despite intervention in S. aureus bacteremia with purulent pericarditis; leaves open optimal prevention and management strategies.

A case with suspected ruptured mycotic coronary aneurysm presenting as purulent bloody pericarditis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

A case with suspected ruptured mycotic coronary aneurysm presenting as purulent bloody pericarditis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider