Abrard Stanislas, Cousin Benoit, Reydel Thomas, Ammi Myriam, Beydon Laurent
Département d'Anesthésie Réanimation, Anesthesiology and Intensive Care Department, Centre Hospitalier Universitaire d'Angers, Angers University Hospital, 4 Rue Larrey, 49100 Angers, France.
Département de Chirurgie Vasculaire et Thoracique, Department of Vascular and Thoracic Surgery, Centre Hospitalier Universitaire d'Angers, Angers University Hospital, 4 Rue Larrey, 49100 Angers, France.
IDCases. 2018 Jun 30;14:e00415. doi: 10.1016/j.idcr.2018.e00415. eCollection 2018.
Aortitis is rare. The etiological diagnosis is difficult but essential for treatment. Even with appropriate treatment mortality remains high. We present a case of pneumococcal aortitis followed by a brief review of the literature.
In this case, the aortic disease was characterized by multiple inflammatory aneurysms. Blood cultures were negative but urine was tested for the presence of pneumococcal urinary antigen postoperatively was positive. Treatment consisted of antibacterial therapy and both surgical and endovascular procedures. The patient was discharged and is well.
Preoperative determination of etiology is crucial in implementing a specific treatment. Pneumococcus is a common bacterium in infectious aortitis. Identification of the causative microbe is necessary to guide antimicrobial therapy. Blood cultures are frequently sterile. The pneumococcal urinary antigen test may be more sensitive than blood cultures, as is the case in pneumococcal pneumonia.
The pneumococcal urinary antigen test may was a useful diagnostic tool in establishing the cause for aortitis in this case. Its potential value should be assessed in furthers studies.
主动脉炎较为罕见。病因诊断困难，但对治疗至关重要。即便进行恰当治疗，死亡率依然很高。我们报告一例肺炎球菌性主动脉炎病例，并对相关文献作简要回顾。
在此病例中，主动脉疾病表现为多发性炎性动脉瘤。血培养结果为阴性，但术后检测尿液中肺炎球菌尿抗原呈阳性。治疗包括抗菌治疗以及外科手术和血管内介入手术。患者出院，情况良好。
术前确定病因对于实施特定治疗至关重要。肺炎球菌是感染性主动脉炎中常见的细菌。确定致病微生物对于指导抗菌治疗很有必要。血培养常常无菌。肺炎球菌尿抗原检测可能比血培养更敏感，就像在肺炎球菌肺炎中一样。
肺炎球菌尿抗原检测在本病例中可能是确定主动脉炎病因的有用诊断工具。其潜在价值应在进一步研究中评估。
