Wang Ling, Lei Wenyi, Qi Fan, Fan Zheyuan
Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Department of Dermatology, The Affiliated Jinyang Hospital of Guizhou Medical University, Guiyang, China.
Heliyon. 2024 Mar 27;10(7):e28735. doi: 10.1016/j.heliyon.2024.e28735. eCollection 2024 Apr 15.
Giant septic pulmonary artery aneurysms (PAAs) are rare but important entities, with few cases having been reported worldwide. Early diagnosis and prompt treatment are crucial in the management of such cases. We report a 56-year-old female patient presenting with fatigue, nausea and vomiting who was first diagnosed with diabetic ketoacidosis (DKA) and developed life-threatening giant infectious PAA secondary to SARS-CoV-2 infection and sepsis. The patient did not develop any specific symptoms, and enhanced computed tomography (CT) revealed a massive PAA of 5.6 × 4.9 cm in size at the left pulmonary hilar with normal pulmonary artery (PA) pressures. After multidisciplinary discussion and after considering the critical condition accompanied by sepsis increased the risk of surgery, endovascular treatment was the first therapy of choice for the patient; nevertheless, the patient ultimately opted for hospice care. This case report aims to raise awareness of PAAs, which are rare but potentially fatal complications of infectious diseases such as COVID-19 pneumonia and sepsis.
巨大感染性肺动脉瘤(PAAs)虽罕见但很重要,全球报道的病例较少。早期诊断和及时治疗对此类病例的管理至关重要。我们报告一名56岁女性患者,最初表现为疲劳、恶心和呕吐,被诊断为糖尿病酮症酸中毒(DKA),继发于SARS-CoV-2感染和脓毒症后发展为危及生命的巨大感染性PAA。患者未出现任何特异性症状,增强计算机断层扫描(CT)显示左肺门处有一个大小为5.6×4.9 cm的巨大PAA,肺动脉(PA)压力正常。经过多学科讨论,并考虑到脓毒症伴随的危急状况增加了手术风险,血管内治疗是该患者的首选治疗方法;然而,患者最终选择了临终关怀。本病例报告旨在提高对PAAs的认识,PAAs是COVID-19肺炎和脓毒症等传染病罕见但可能致命的并发症。