Lizarazo Jimenez Maria J, Campaña Perilla Laura, Olarte Salazar Carlos M, Iregui Cantor Eduardo A
Internal Medicine, University Hospital Fundación Santa Fe de Bogotá, Bogota, COL.
Radiology, University Hospital Fundación Santa Fe de Bogotá, Bogota, COL.
Cureus. 2025 Aug 18;17(8):e90427. doi: 10.7759/cureus.90427. eCollection 2025 Aug.
Takayasu arteritis (TA) is a rare, immune-mediated large-vessel vasculitis that primarily affects the aorta and its major branches. While several infectious agents have been implicated as potential environmental triggers, necrotizing fasciitis (NF) has not been previously linked to the onset of TA. We report the case of a previously healthy 33-year-old woman who developed rapidly progressive TA following NF of the left lower limb. Despite broad-spectrum antibiotics and surgical debridement, the patient exhibited persistent fever, leukocytosis, and new-onset hypertension. Imaging revealed new inflammatory changes in the thoracic and abdominal aorta, consistent with large-vessel vasculitis. A diagnosis of TA was established based on the findings of magnetic resonance angiography. Following high-dose corticosteroid therapy, the patient showed rapid clinical improvement. Cyclophosphamide was initiated, and follow-up imaging confirmed partial resolution of vascular inflammation. This case highlights NF as a potential immunologic trigger for TA. In patients with persistent systemic inflammation despite adequate infection control, autoimmune vasculitis should be considered as a possible underlying cause. Early diagnosis and prompt immunosuppressive therapy can lead to significant clinical improvement.
高安动脉炎(TA)是一种罕见的、免疫介导的大血管血管炎,主要累及主动脉及其主要分支。虽然几种感染因子被认为是潜在的环境触发因素,但坏死性筋膜炎(NF)此前尚未与TA的发病相关联。我们报告了一例先前健康的33岁女性病例,该患者在左下肢发生NF后迅速发展为进行性TA。尽管使用了广谱抗生素并进行了手术清创,但患者仍持续发热、白细胞增多,并出现了新发高血压。影像学检查显示胸主动脉和腹主动脉出现新的炎症改变,符合大血管血管炎。根据磁共振血管造影的结果确诊为TA。在接受大剂量皮质类固醇治疗后,患者临床症状迅速改善。开始使用环磷酰胺治疗,后续影像学检查证实血管炎症部分消退。该病例突出了NF作为TA潜在免疫触发因素的作用。对于尽管感染得到充分控制但仍存在持续全身炎症的患者,应考虑自身免疫性血管炎作为可能的潜在病因。早期诊断和及时的免疫抑制治疗可带来显著的临床改善。