Purulent pericarditis, an unusual cause of cardiac arrest.

Purulent pericarditis is a rare infection of the pericardial space defined by the presence of gross pus or microscopic purulence. Here, we present a case of Streptococcus anginosus purulent pericarditis, leading to obstructive and septic shock. After prompt pericardial drainage, the patient experienced rapid improvement in symptoms. However, due to the presence of a loculated effusion and concern for development of constrictive pericarditis, a pericardial window was performed. Although purulent pericarditis is often fatal, this case illustrates the reduced morbidity following prompt recognition and drainage.

An unusual case of iatrogenic haemoptysis.

Summary Transbronchial needle aspiration (TBNA) of the hilar and mediastinal lymph nodes and lung masses is a powerful tool in the diagnostic evaluation of mediastinal adenopathies including malignancies. As its use becomes more widespread, few cases have been reported with complications. We present a case of a 57-year-old man who was transferred to our institution for uncontrolled haemoptysis following endobronchial ultrasound-guided TBNA. At our institution, emergent bronchoscopy revealed a large clot distal to the right upper lobe bronchus without a visible fistula tract. A CT pulmonary angiogram and a subsequent pulmonary angiogram showed an aneurysm originating from the right superior pulmonary vein. Management was conservative with strict blood pressure control and lowering the left atrial pressure allowed spontaneous resolution of the bleed.