Purulent effusive-constrictive pericarditis and infective native aortic aneurysm: a case report

Non-typhoid Salmonella is a common foodborne infection.[1] In the setting of immunosuppression, the classical symptom of diarrhea, that is an immune defense mechanism, may be absent [2,3] allowing the bacteria to hematogenous spread and settle in other organs.[4,5] As a result, in the setting of acute pericarditis in immunosuppressed patients, a bacterial etiology must always be considered, which requires pericardiocentesis to complete drainage and pathogen identification.[6] We report a case of a 63-year-old female under corticotherapy due to discoid lupus erythematous with a delayed diagnosis of effusive-constrictive pericarditis with a concomitant infective native aortic pseudoaneurysm.This is the second reported case of effusive-constrictive pericarditis and infective native aortic pseudoaneurysm caused by salmonellosis, [7] the first one in Europe.A 63-year-old female presented to the emergency department with a five-day history of fever (maximum 38 ℃), non-productive cough, and pleuritic chest pain.The patient had been diagnosed with COVID-19 infection one week prior.The patient had a medical history of discoid lupus erythematosus and was currently taking prednisolone.In the context of iron deficiency anemia, eight months before, she underwent a colonoscopy with polypectomy.At admission, the patient's physical examination was unremarkable.The initial blood test results showed leukocytosis (13,300/L) with neutrophilia (10,100/L) and high C-reactive protein (15.7 mg/dL).The high-sensitivity troponin T was slightly elevated and subsequently decreased.The 12-lead electrocardiogram (ECG) revealed sinus rhythm with concave upward STsegment elevation in leads V5, V6, DI, DII and aVL, as well as upward PR-segment elevation in aVR.The chest X-ray revealed cardiomegaly, without consolidation or lung congestion.