Sato Taiki, Okamoto Yuki, Yamamoto Kazuo, Mizuochi Rie, Yamamoto Soshi, Takahashi Satoshi, Asami Fuyuki, Katsu Masatake, Yoshii Shinpei
Department of Cardiovascular Surgery, Tachikawa Medical Center, Nagaoka, Japan.
Kyobu Geka. 2022 Feb;75(2):146-149.
The objective of this case report is to highlight a rare case of infectious thoracic aortic aneurysm and purulent pericarditis simultaneously in a 56-year-old woman. The patient complained of left anterior chest pain and contrast computed tomography (CT) revealed infectious thoracic aortic aneurysm and purulent pericarditis accompanied by massive pericardial effusion. She underwent a pericardial drainage immediately, and antibiotic treatment was initiated. Methicillin-sensitive Staphylococcus aureus was detected in blood and pericardial fluid cultures. On day eight of hospitalization, contrast CT scan showed enlargement of the aortic aneurysm. Therefore, total arch replacement was performed on day 10 using rifampicin-soaked graft. After surgery, antibiotic treatment was continued, till inflammatory markers became negative. She was discharged on day 66 without developing anastomotic pseudoaneurysms nor constrictive pericarditis.
本病例报告的目的是强调一名56岁女性同时发生感染性胸主动脉瘤和化脓性心包炎的罕见病例。患者主诉左前胸疼痛，对比增强计算机断层扫描（CT）显示感染性胸主动脉瘤和化脓性心包炎，并伴有大量心包积液。她立即接受了心包引流，并开始使用抗生素治疗。血液和心包液培养均检测到对甲氧西林敏感的金黄色葡萄球菌。住院第8天，对比增强CT扫描显示主动脉瘤增大。因此，在第10天使用浸有利福平的移植物进行了全弓置换术。术后继续使用抗生素治疗，直至炎症指标转阴。她于第66天出院，未发生吻合口假性动脉瘤或缩窄性心包炎。
