Hakim Seifeldin, Davila Francisco, Amin Mitual, Hader Ismail, Cappell Mitchell S
Department of Medicine, Division of Gastroenterology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073, USA.
Case Rep Med. 2018 Apr 1;2018:6845617. doi: 10.1155/2018/6845617. eCollection 2018.
A 65-year-old Japanese man living in the United States presented with pyrexia and chills associated with intermittent lower abdominal and back pain for 5 days. He denied recent travel, rash, diarrhea, or rectal bleeding. Physical examination revealed spiking pyrexia, and routine laboratory tests revealed mild leukocytosis and neutrophilia. Abdominal CT with contrast showed findings highly compatible with aortitis. Comprehensive autoimmune evaluation was negative. serotype Enteritidis was isolated from blood cultures. IV antibiotics were administered, but the patient continued to experience low-grade pyrexia and mild leukocytosis, and follow-up abdominal CT showed progressive aortic inflammation. The patient therefore underwent resection of the affected aortic segment with in-situ graft replacement and lifelong suppressive antibiotics. The patient is asymptomatic with no complications at 18 weeks of follow-up. This case report illustrates that patients with infectious aortitis from nontyphoidal may (1) present with nonspecific and nonlocalizing symptoms and signs except for sepsis; (2) have diagnostic blood cultures and abdominal CT findings; and (3) typically require aggressive, prolonged IV antibiotic therapy and surgery for potential cure of this life-threatening infection.
一名居住在美国的65岁日本男性，出现发热和寒战，并伴有间歇性下腹部和背部疼痛5天。他否认近期有旅行史、皮疹、腹泻或直肠出血。体格检查发现体温波动，常规实验室检查显示轻度白细胞增多和中性粒细胞增多。腹部增强CT显示的结果与主动脉炎高度相符。全面的自身免疫评估为阴性。血培养分离出肠炎血清型。给予静脉抗生素治疗，但患者仍持续低热和轻度白细胞增多，后续腹部CT显示主动脉炎症进展。因此，患者接受了病变主动脉段切除并原位移植置换术以及终身抑制性抗生素治疗。在随访18周时，患者无症状且无并发症。本病例报告表明，非伤寒性感染性主动脉炎患者可能（1）除败血症外，表现为非特异性和无定位症状及体征；（2）有诊断性血培养和腹部CT表现；（3）通常需要积极、长期的静脉抗生素治疗和手术，以潜在治愈这种危及生命的感染。
