Many Different Patterns under a Common Flag: Aortic Pathology in HIV—A Review of Case Reports in Literature

Silvestri, Valeria; d’Ettorre, Gabriella; Borrazzo, Cristian; Mele, Rita

doi:10.1016/j.avsg.2019.01.016

Cited by 20 publications

(22 citation statements)

References 51 publications

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“…Staphylococcus aureus and Salmonella species were reported to cause AD [5]. Virus infection such as herpes zoster, human immunode ciency virus and varicella-zoster virus, can also lead to vascular dissection [12]. However, the exact mechanisms of infection related vascular dissection are still far from clear.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic fever with renal syndrome with concurrent aortic dissection: a case report

Qiu¹,

Li²,

Zhou³

2020

Preprint

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Background Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses presenting with high fever, hemorrhage, acute kidney injury. Microvascular injury and hemorrhage in mucus was often observed in patients with hantavirus infection. Infection with bacterial and virus related aortic aneurysm or dissection occurs sporadically. We present a previously unreported case of hemorrhagic fever with concurrent Stanford B aortic dissection. Case presentation: A 56-year-old man complained of high fever, generalized body ache, with decreased platelet counts of 10 × 10^9/L and acute kidney injury. The ELISA test for Hantaan virus of IgM and IgG antibodies were both positive. During the convalescent period, he complained sudden onset acute chest pain radiating to the back and the CTA revealed an aortic dissection of the descending aorta extending to iliac artery. He was diagnosed with Hemorrhagic fever with renal syndrome and Stanford B aortic dissection. The patient recovered completely after surgery with other support treatments. Conclusion We present a case of HFRS complicated with aortic dissection,and no study has reported the association of HFRS with aortic disease. However, we suppose that hantavirus infection not only cause microvascular damage but may be risk factor for acute macrovascular detriment. A causal relationship has yet to be confirmed.

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Section: Discussionmentioning

confidence: 99%

Hemorrhagic fever with renal syndrome with concurrent aortic dissection: a case report

Qiu¹,

Li²,

Zhou³

2020

Preprint

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“…MAAs usually occur in the elderly, predominantly affecting immunocompromised patients, such as diabetes mellitus, liver cirrhosis, end-stage renal disease, alcoholism, chronic glucocorticoid therapy, post-transplantation immunosuppression, human immunodeficiency virus infection, drug abuse, and malignancy (14)(15)(16)(17). The known causative organisms of MAAs are Salmonella, Staphylococcus aureus, Klebsiella pneumoniae (KP), Escherichia coli, Mycobacterium, and Brucella melitensis.…”

Section: Pathogenesismentioning

confidence: 99%

Imaging features of mycotic aortic aneurysms

Zhang¹,

Xiong²,

Liu³

et al. 2021

Quant Imaging Med Surg

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Infectious aortitis (IA) is a rare and life-threatening cardiovascular disease. Early diagnosis and timely intervention are crucial for reducing mortality associated with mycotic aortic aneurysms (MAAs); however, early diagnosis is challenging due to the nonspecific symptoms. Some cases are diagnosed at an advanced stage or after developing complications, such as rupture or aortic fistula. Current state-of-theart imaging modalities-including computed tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT-can detect infected aneurysms in clinically suspicious cases. MAA features on imaging include lobulated pseudoaneurysm, indistinct irregular arterial wall, perianeurysmal gas, perianeurysmal edema, perianeurysmal soft tissue mass, aneurysmal thrombosis, and high metabolic activity with increased uptake of FDG. Enlarged lymph nodes are often found adjacent to the aneurysm, while iliopsoas abscess (IPA), spondylitis, and aortic fistulas are commonly associated complications. After surgery or endovascular repair, radiological features-including ectopic gas, peri-graft fluid, thickening of adjacent bowel, pseudoaneurysm formed at the graft anastomosis, and increased uptake of FDG-may indicate an infection of aortic graft. This article provides an overview of the clinical and imaging features of MAAs. Thus, familiarity with the imaging appearances of MAAs may assist radiologists in the diagnosis and facilitation of timely treatment.

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“…The vasculitis may occur in all ranges of CD4, independent of viral load, and in patients after starting antiviral therapy suggesting an immune reconstitution inflammatory syndrome (IRIS) [ 35 ••, 36 , 37 ]. A further observation was the lower use of conventional and biological DMARD in patients with HIV-associated vasculitis.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…These complications are considered emergencies and therefore should be prioritized regardless of the immune status. Treatment should be individualized and prioritized to patients with symptomatic aneurysmal lesion and acute arterial occlusion [ 31 , 32 •, 36 , 37 ]. Interventional or surgical therapy is indicated if a vascular lesion that persists despite medical therapy is either symptomatic or is associated with an increased risk of future complications.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Vasculitides in HIV Infection

Vega¹,

Espinoza

2020

Curr Rheumatol Rep

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Purpose of Review To review the spectrum of vasculitides in HIV-infected patients and to identify the clinical features that characterize vasculitis in sero-positive HIV. Recent Findings Epidemiological studies conducted in the post-HAART era described the rarity of vasculitis in the setting of HIV-infected patients. A study identified histopathological features such as leukocytoclastic vasculitis of the vasa vasorum and adventitial inflammation in the large artery pathology of HIV-positive patients compared with HIV-negative patients with critical lower limb ischemia. A recent retrospective cohort study reported that HIV-positive patients with LVV developed more vascular complications, responded less to antiretroviral therapy, and had worse outcome than HIV-negative patients with LVV. Summary Vasculitides continue to be a rare disease in patients with HIV. The spectrum of vasculitis ranges from life-threatening conditions to relatively mild skin conditions. Recognizing vasculitis in the setting of HIV-positive patients is important because sometimes it require immunosuppressive treatment.

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Many Different Patterns under a Common Flag: Aortic Pathology in HIV—A Review of Case Reports in Literature

Cited by 20 publications

References 51 publications

Hemorrhagic fever with renal syndrome with concurrent aortic dissection: a case report

Hemorrhagic fever with renal syndrome with concurrent aortic dissection: a case report

Imaging features of mycotic aortic aneurysms

Vasculitides in HIV Infection

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