Staphylococcal thoracic aortitis complicated by aortic dissection
10.5847/wjem.j.issn.1920-8642.2013.02.013
- Author:
Paul Chun Yih LIM
1
;
Jean Mui Hua LEE
;
Chua Leng YEOW
;
Chia STANLEY
Author Information
1. National Heart Centre Singapore
- Publication Type:Journal Article
- Keywords:
Aneurysm;
Aortic diseases;
Endovascular stent;
Infected/microbiology;
Staphalococcus aureus
- From:
World Journal of Emergency Medicine
2013;4(2):154-156
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: The diagnosis of aortitis is often delayed as symptoms are largely non-specific. We report a case of Staphylococcal thoracic aortitis in a 73-year-old Chinese woman complicated by aortic dissection. METHODS: The patient presented with pyrexia of unknown origin, and a contrast enhanced computed tomography aortogram revealed a large thrombus at the anterior aspect of the ascending aorta with two large ulcerations as a result of a chronic type A aortic dissection. A hemiarch replacement with a 28 mm Gleweave Vascutek graft was performed with resuspension of aortic valve commisures. Aortic thrombus cultures were positive for coagulase negative Staphylococcus aureaus, and histology showed chronic dissection of the aorta. RESULTS: The patient was treated with intravenous cefazolin for a 6-week duration and made good progress. CONCLUSIONS: This case highlights Staphylococcal infective aortitis complicated by dissection presenting as fever of unknown origin. Timely diagnosis is essential as progression to catastrophic rupture may occur.