Non-Aneurysmal Infectious Aortitis: A Case Report

Infectious Thoracic Aortitis: A Literature Review

“…Infection of the aorta can arise by several mechanisms: (1) bacteremic seeding of an existing intimal injury or atherosclerotic plaque (the most common mechanism), (2) septic emboli of the aortic vasa vasorum (once the most common cause, typically in bacterial endocarditis), (3) contiguous infective focus extending to the aorta wall (rare), and (4) direct bacterial inoculation at the time of trauma, such as a penetrating injury. 1,3,4 Risk factors for aortic infections are obviously the same as those for atherosclerosis, but also IE, aortic trauma (such as a complication of aortic angiography), congenital aortic anomalies (suchsd coarctation and patent ductus arteriosus), and conditions causing impaired immunity (such as cancer, diabetes, alcoholism, and immunosuppressive therapies). 1,8 …”

“…1 Patients with no aneurysm formation are likely to be less symptomatic. 4 Mycotic aneurysms can cause compressive 488 Clin. Cardiol.…”

“…2 However, diagnosis is frequently delayed since clinical manifestations are usually nonspecific or the first symptoms often result from expansion or rupture of an aneurysm. Infectious thoracic aortitis should always be considered in elderly patients with atherosclerosis, history of thoracic, abdominal, or back pain, and vague symptoms such as nausea, vomiting, and fever 4 Leukocytosis and neutrophilia are present in 65% to 83% of cases. 1 Erythrocyte sedimentation rate and C-reactive protein are elevated in most of the patients.…”

“…However, an MA usually develops when a preexisting aneurysm becomes secondarily infected. 4 Mycotic aneurysms represent 2.6% of all aortic aneurysms, the thoracic aorta is the least common site of occurrence. 1 In most of the reports, IA presents with an aneurysm, and it is impossible to determine if the aneurysm was already there when the infection began.…”

“…1 In most of the reports, IA presents with an aneurysm, and it is impossible to determine if the aneurysm was already there when the infection began. 4 Furthermore, there are only a few cases in the literature describing IA in the absence of an aneurysm or rupture. 3,5,6,7 Infectious thoracic aortitis has a male predominance (male:female ratio = 3:1) and the mean age at diagnosis is 65 years old.…”