Robinson William P, Schuksz Manuela
Division of Vascular and Endovascular Surgery, University of Massachusetts Medical School, Worcester, MA, USA
Division of Vascular and Endovascular Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
Vasc Endovascular Surg. 2016 May;50(4):290-4. doi: 10.1177/1538574416642876. Epub 2016 Apr 12.
Coxiella burnetii, the etiologic agent of Q fever, has been associated with vascular infection and aneurysm formation. We report the case of a 36-year-old woman from Iraq who presented with long-standing malaise as well as vague chest and shoulder discomfort and was found to have a saccular aneurysm of the descending thoracic aorta. Serology assays were positive for chronic C burnetii infection. She was treated with successful aneurysm resection and aortic replacement with a rifampin-impregnated Maquet Hemashield (TM) Dacron interposition graft interposition graft in addition to 18 months of doxycycline and hydroxychloroquine. The patient is without evidence of recurrent infection on follow-up at 3 years. To our knowledge, this is the first case of aortic aneurysm secondary to Q fever reported in the United States. We review the diagnosis, surgical management, antibiotic therapy, and surveillance of a thoracic aortic aneurysm secondary to Q fever.
Q热的病原体伯纳特立克次体与血管感染和动脉瘤形成有关。我们报告了一例来自伊拉克的36岁女性病例，该患者长期感到不适，伴有胸部和肩部隐痛，经检查发现降主动脉有一个囊状动脉瘤。血清学检测显示慢性伯纳特立克次体感染呈阳性。她接受了动脉瘤切除术，并成功进行了主动脉置换，使用了浸有利福平的马凯特Hemashield（TM）涤纶人工血管，此外还接受了18个月的强力霉素和羟氯喹治疗。该患者在3年的随访中没有复发感染的迹象。据我们所知，这是美国报告的首例继发于Q热的主动脉瘤病例。我们回顾了继发于Q热的胸主动脉瘤的诊断、手术治疗、抗生素治疗及监测情况。
