Akashi Y, Ikehara Y, Yamamoto A, Suzuki N, Osada N, Matsumoto N, Sakakibara M, Tochiki H, Tanabe K, Nobuoka S, Miyake F, Murayama M, Abe H, Ikeshita M, Yamate N, Kaku M, Shimada J
The Second Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan.
Jpn Circ J. 2000 Jan;64(1):83-6. doi: 10.1253/jcj.64.83.
A 61-year-old female, with a history of uterine and cervical cancer treated with radical hysterectomy and 2 years of postoperative chemotherapy, presented to the emergency department with dyspnea on exertion. Computed tomography of the chest revealed a large pericardial effusion and a sacciform aneurysm of the ascending aorta. The patient subsequently underwent emergency pericardiocentesis with drainage of approximately 330 ml of a bloody and turbid effusion. Cultures from the effusion yielded group B streptococcus. Multiple organ failure and disseminated intravascular coagulation syndrome occurred in the acute phase, but gradually improved with continuous antibiotic therapy. On the 194th hospital day, in situ reconstruction of the ascending aorta was successfully performed using a synthetic graft. Although rarely reported, both purulent bacterial pericarditis and mycotic aneurysm can be life-threatening.
一名61岁女性，有子宫颈癌病史，接受过根治性子宫切除术及术后2年化疗，因劳力性呼吸困难就诊于急诊科。胸部计算机断层扫描显示大量心包积液及升主动脉囊状动脉瘤。患者随后接受了紧急心包穿刺术，引流出约330毫升血性浑浊积液。积液培养出B组链球菌。急性期出现多器官功能衰竭和弥散性血管内凝血综合征，但经持续抗生素治疗后逐渐好转。在住院第194天，使用人工血管成功进行了升主动脉原位重建。尽管报道较少，但化脓性细菌性心包炎和霉菌性动脉瘤均可能危及生命。
