General Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA.
General Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA
BMJ Case Rep. 2024 Mar 27;17(3):e257509. doi: 10.1136/bcr-2023-257509.
Infectious aortitis is a rare disease process which can be of fungal, viral or bacterial aetiology. This disease process is often incidentally found during concomitant infectious processes, likely due to haematogenous spread. Common sources are from cardiac, genitourinary and gastroenterologic sources. CT imaging of the aorta is essential in identifying physiological changes-wall thickness changes, ectasia and stenosis. We present a case of a female in her early 60s with a medical history of cardiomyopathy with heart failure and reduced ejection fraction, who was initially admitted for acute cholecystitis complicated by the development of gallstone pancreatitis. Imaging evaluation incidentally noted findings consistent with aortitis with a penetrating ulcer, and blood cultures were positive for bacteraemia, confirming her diagnosis of infectious aortitis. She was started on intravenous antibiotics, required preoperative nutritional optimisation, and subsequently underwent an open aortic resection and aortoiliac reconstruction with rifampin-soaked Dacron graft.
感染性动脉炎是一种罕见的疾病过程，可由真菌、病毒或细菌引起。这种疾病过程通常是在伴随的感染过程中偶然发现的，可能是由于血源性播散所致。常见的来源是心脏、泌尿生殖和胃肠来源。主动脉的 CT 成像对于识别生理变化-壁厚度变化、扩张和狭窄至关重要。我们报告了一位 60 多岁女性的病例，她有心肌病伴心力衰竭和射血分数降低的病史，最初因急性胆囊炎并发胆石性胰腺炎入院。影像学评估偶然发现了符合穿透性溃疡的动脉炎的表现，血培养阳性为菌血症，证实了她感染性动脉炎的诊断。她开始接受静脉注射抗生素治疗，需要术前营养优化，随后接受了开放式主动脉切除术和腹主动脉-髂动脉重建术，使用利福平浸泡的涤纶移植物。
