Maillet Jean Michel, Palombi Tonino, Sablayrolles Jean-Louis, Bonnet Nicolas
Department of Cardiovascular and Thoracic Surgery, Centre Cardiologique du Nord, Saint-Denis, France.
Interact Cardiovasc Thorac Surg. 2012 Oct;15(4):790-1. doi: 10.1093/icvts/ivs251. Epub 2012 Jun 22.
Infectious aortitis has become a rare disease thanks to the widespread use of antibiotics. We report the case of a patient who, 15 days after initiation of antibiotics for bacteraemia due to methicillin-resistant Staphylococcus aureus (MRSA), developed acute chest pain followed by haemodynamic instability. A tamponade due to a rupture into the pericardium of the ascending aorta at the site of an atherosclerotic plaque was diagnosed by an emergent chest contrasted computed tomography (CT). Intraoperatively, the septic nature of the rupture was suspected. All aortic atherosclerotic plaque samples grew MRSA. Postoperatively, the patient had an uneventful recovery after 12 weeks of antibiotic therapy. Transoesophageal echocardiography and chest CT were normal at 3 months after cessation of antibiotics. This case report permits the review of some characteristics of this disease, its physiopathology as well as the therapeutic implications.
由于抗生素的广泛使用，感染性主动脉炎已成为一种罕见疾病。我们报告了一例患者，该患者因耐甲氧西林金黄色葡萄球菌（MRSA）引起的菌血症接受抗生素治疗15天后，出现急性胸痛，随后出现血流动力学不稳定。急诊胸部增强计算机断层扫描（CT）诊断为升主动脉粥样硬化斑块部位破裂进入心包导致心包填塞。术中怀疑破裂具有感染性。所有主动脉粥样硬化斑块样本均培养出MRSA。术后，患者在接受12周抗生素治疗后顺利康复。抗生素停用3个月后，经食管超声心动图和胸部CT检查均正常。本病例报告有助于回顾该疾病的一些特征、病理生理学以及治疗意义。
