Krypciak S, Baudry E, Louis N, Mayer J, Taillandier-Heriche E, Laurent M, Allaire E, Paillaud E
Département de Médecine Interne et de Gériatrie, Université Paris Est-Créteil, Groupe Hospitalier Universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
J Mal Vasc. 2011 Dec;36(6):355-63. doi: 10.1016/j.jmv.2011.08.002. Epub 2011 Oct 19.
We report on a case of Clostridium septicum aortic mycotic aneurysm in an 83-year-old patient. This is a rare infectious disease. To our knowledge, only 31 cases have been reported in the literature. The clinical presentation is dominated by abdominal pain with fever. Although only the bacteriological samples can definitely identify the germ, the presence of gas bubbles around an aneurysm on abdominal computed tomography scan suggests C. septicum aortic infection. This infectious disease is frequently associated with neoplasia, mainly colonic. Treatment is primarily surgical resection with bypass or graft, associated with prolonged antibiotic therapy. The prognosis is poor due to vascular complications and pathogenesis of C. septicum. Patients cumulate the death risk from mycotic aneurysm and C. septicum sepsis.
我们报告一例83岁患者发生的败血梭菌性主动脉真菌性动脉瘤。这是一种罕见的感染性疾病。据我们所知，文献中仅报道了31例。临床表现以腹痛伴发热为主。虽然只有细菌学样本才能明确鉴定病原体，但腹部计算机断层扫描显示动脉瘤周围存在气泡提示败血梭菌性主动脉感染。这种感染性疾病常与肿瘤形成相关，主要是结肠癌。治疗主要是手术切除并进行搭桥或移植，同时进行延长的抗生素治疗。由于血管并发症和败血梭菌的发病机制，预后较差。患者累积了真菌性动脉瘤和败血梭菌败血症的死亡风险。
