Description

A 53-year-old man with history of poorly controlled diabetes mellitus presented with left chest pain radiated to the left shoulder for 3 weeks. On examination, he had low-grade fever, tachypnoea, regular pulse rate at 90/min and blood pressure 140/90 mm Hg. His cardiovascular and chest examinations were otherwise unremarkable.

Initial blood test showed leucocytosis and elevated C reactive protein level. Chest radiograph revealed abnormal soft tissue density silhouette with proximal descending aorta with air-filled collection (figure 1, arrow).