Sanei Taheri Morteza, Nekooghadam Sayyed Mojtaba, Tabatabaei Zahra Sadat, Rezaei Sahar
Department of Radiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Shohada-e-Tajrish Hospital, Tehran, Iran.
Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Shohada-e-Tajrish Hospital, Tehran, Iran.
Arch Acad Emerg Med. 2024 Jan 7;12(1):e23. doi: 10.22037/aaem.v12i1.2203. eCollection 2024.
Aortitis is the inflammation of the aortic wall. It can be caused by both infectious and non-infectious etiologies. Mycotic aneurysm is a rare, serious medical condition and typically requires prompt treatment with antibiotics, surgical intervention, or endovascular procedures to prevent rupture and complications. Here we reported, a 66-year-old male patient with a medical history of diabetes and hypertension, who presented to the emergency department (ED) with left-sided hemiplegia. Brain magnetic resonance imaging (MRI) revealed infarction in the right parietooccipital and left occipital lobes, demonstrating an embolic pattern. laboratory analysis revealed elevated levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC). In order to investigate the possibility of sepsis, a non-contrast chest computed tomography (CT) scan was performed, which showed a soft tissue density surrounded by gas in the posterior mediastinum; for which the rupture of esophagus and infected aorta pseudoaneurysm were among differential diagnoses. To confirm the diagnosis, CT angiography was ordered. The infected ruptured pseudo-aneurysm(s) was confirmed and patient underwent thoracotomy surgery.
主动脉炎是主动脉壁的炎症。它可由感染性和非感染性病因引起。真菌性动脉瘤是一种罕见的严重病症,通常需要迅速使用抗生素、手术干预或血管内介入治疗,以防止破裂和并发症。在此我们报告,一名66岁男性患者,有糖尿病和高血压病史,因左侧偏瘫就诊于急诊科。脑部磁共振成像(MRI)显示右侧顶枕叶和左侧枕叶梗死,呈栓塞模式。实验室分析显示红细胞沉降率(ESR)、C反应蛋白(CRP)和白细胞(WBC)水平升高。为调查脓毒症的可能性,进行了非增强胸部计算机断层扫描(CT),结果显示后纵隔有一个软组织密度影,周围有气体;鉴别诊断包括食管破裂和感染性主动脉假性动脉瘤。为明确诊断,安排了CT血管造影检查。确诊为感染性破裂假性动脉瘤,患者接受了开胸手术。