Fatal cardiac tamponade in a child due to rupture of a mycotic aneurysm. (Images in Cardiology).(Brief Article)

A 3 year old child presented with a three week history of febrile illness associated with pharyngitis and erythema. A throat swab was positive for type A [beta] haemolytic streptococcus. Two dimensional echocardiography revealed pericardial effusion with drainage of a total of 500 ml of blood. The child suddenly developed hypotension and cyanosis, and died despite efforts to resuscitate.

At postmortem examination, we located a massive haemopericardium caused by external rupture of a saccular aneurysm of the ascending aorta (12 mm in diameter) (A, arrowhead), with the entry (boxed area) located 1 cm above the semilunar leaflets of the aortic valve. No infective …