Case of ruptured S<i>taphylococcus aureus</i>aortitis: presentation and management

Wang, Stephani C.; Tageldin, Mohamed Awad; Hand, Drinnon O

doi:10.1136/bcr-2018-225514

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Our case also did not show clear symptoms, and sudden cardio-respiratory arrest occurred due to acute massive bleeding. The risk factors of poor prognosis are female, elderly, Staphylococcus aureus infection, aneurysm rupture, lack of surgical treatments, aneurysm located above renal arteries, and extensive infection around periaortic site [4,5]. Risk factors in our case included an elderly female, MRSA infection, lack of surgical treatment, rupture of the aorta, aneurysm located above renal arteries, and extensive infection around periaortic site.…”

Section: Discussionmentioning

confidence: 95%

An Autopsy Case of Rupture of Infectious Thoracic Aortitis Induced by Methicillin-Resistant Staphylococcus Aureus

Goto

Adachi

Doi³

et al. 2019

Am J Case Rep

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Patient: Female, 83Final Diagnosis: Rupture of infectious thoracic aortitisSymptoms: Cardiac pulmonary arrestMedication: —Clinical Procedure: MedicationSpecialty: PathologyObjective:Rare diseaseBackground:Infectious aortitis has a poor prognosis and high mortality rate if untreated. Here, we report a case of rupture of infectious aortitis induced by methicillin-resistant staphylococcus aureus (MRSA).Case Report:An 83-year-old female patient was hospitalized due to continuous fever and diarrhea, which was diagnosed as colitis. The colitis was determined to have been induced by small vessel vasculitis upon histological examination. Fasting and central venous hyperalimentation using a peripherally inserted central catheter (PICC) were carried out for rest of the intestine. Swelling and pus were observed at the insertion site of the PICC. Since methicillin resistant staphylococcus aureus (MRSA) was detected in the culture of the pus and the blood, the patient was treated with vancomycin. After confirming that the blood culture became negative, prednisolone (PDL) was started as therapy for the colitis. Her diarrhea and fever improved. After vancomycin was stopped, MRSA-arthritis appeared. She suddenly died due to acute massive hemorrhage into the mediastinum and left thoracic cavity from the atherosclerotic ulcer of the thoracic aorta. It took 98 days from the first detection of MRSA in her blood to her death. We found gram-positive coccus in the ruptured aortic ulcer and we also detected MRSA gene by polymerase chain reaction in the ulcer. These results suggest that MRSA could colonize in the aortic ulcer during the MRSA-bacteremia and the MRSA could contribute to the vulnerability of the aortic wall.Conclusions:After septicemia occurrs in an elderly person, the patient should be followed up by considering infectious aortitis, especially when the patient has several risk factors.

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Section: Discussionmentioning

confidence: 95%

An Autopsy Case of Rupture of Infectious Thoracic Aortitis Induced by Methicillin-Resistant Staphylococcus Aureus

Goto

Adachi

Doi³

et al. 2019

Am J Case Rep

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“…Many bacterial germs can cause aortitis. The most common are gram-positive cocci, Staphylococcus aureus, and Streptococcus, the latter often being implicated in the occurrence of aortic aneurysm in the context of infectious endocarditis [20][21][22]. Cases of Salmonella aortitis have also been reported, mainly in the abdominal aorta [23,24].…”

Section: Other Infectious Causesmentioning

confidence: 99%

Mimickers of Large Vessel Giant Cell Arteritis

Greigert

Ornetti²,

Bonnotte

et al. 2022

JCM

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Giant cell arteritis (GCA) is a large-vessel granulomatous vasculitis occurring in patients over 50-year-old. Diagnosis can be challenging because there is no specific biological test or other diagnoses to consider. Two main phenotypes of GCA are distinguished and can be associated. First, cranial GCA, whose diagnosis is usually confirmed by the evidence of a non-necrotizing granulomatous panarteritis on temporal artery biopsy. Second, large-vessel GCA, whose related symptoms are less specific (fever, asthenia, and weight loss) and for which other diagnoses must be implemented if there is neither cephalic GCA nor associated polymyalgia rheumatica (PMR) features chronic infection (tuberculosis, Coxiella burnetti), IgG4-related disease, Erdheim Chester disease, and other primary vasculitis (Behçet disease, relapsing polychondritis, or VEXAS syndrome). Herein, we propose a review of the main differential diagnoses to be considered regarding large vessel vasculitis.

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