Beyond the echocardiography: infection-related pseudoaneurysm in a paediatric patient with repaired tetralogy of Fallot.

A one-year-old boy with repaired tetralogy of Fallot presented with recurrent fever. Blood cultures grew Streptococcus mitis/oralis, but transthoracic echocardiography showed no infective endocarditis. Cardiac CT angiography revealed an occult right ventricular outflow tract pseudoaneurysm, which was surgically resected. This case highlights CT angiography as a critical diagnostic tool when echocardiography fails to identify infectious sources in CHD.