Department of Infectious Diseases, Rakuwakai Otowa Hospital, Japan.
Department of Intensive Care, Hyogo Prefectural Amagasaki General Medical Center, Japan.
Intern Med. 2024 May 15;63(10):1505-1509. doi: 10.2169/internalmedicine.2411-23. Epub 2023 Oct 6.
Infected aortic aneurysms are rare, and have a high mortality rate. Although not a major pathogen, Streptococcus pyogenes has been reported to cause infected aortic aneurysms. In the present case, the patient was hospitalized for pyogenic flexor tenosynovitis with S. pyogenes bacteremia. Despite drainage of the abscess around the flexor tendon and effective antimicrobial therapy, infected aneurysms developed in the abdomen and ascending aorta. Because of their rapid enlargement, these aneurysms were treated with in situ reconstruction. Although rare, the possibility that S. pyogenes is the causative pathogen of infected aortic aneurysms should be considered.
感染性主动脉瘤较为罕见,且死亡率较高。虽然酿脓链球菌并非主要病原体,但已有报道称其可引起感染性主动脉瘤。本病例中,患者因酿脓链球菌菌血症合并化脓性屈肌腱腱鞘炎而住院治疗。尽管对屈肌腱周围脓肿进行了引流,并给予了有效的抗菌治疗,但仍在腹部和升主动脉处发展为感染性动脉瘤。由于这些动脉瘤迅速增大,采用原位重建进行了治疗。尽管较为罕见,但仍应考虑酿脓链球菌是感染性主动脉瘤的致病病原体的可能性。