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[Thoracic aortic aneurysm in the setting of metastatic mediastinitis]
1Institut für Pathologie an der BG Klinik Bergmannsheil-Universitätsklinik, Ruhr-Universität Bochum, elisabeth.harrer@ruhr-uni-bochum.de
Abstract:
The aetiological spectrum of thoracic aortic aneurysms is extensive. Infectious aneurysms (formerly mycotic aneurysms) constitute only a small percentage of all thoracic aortic aneurysms, they are usually small and often develop as complications of bacterial endocarditis. We report the case of a 39-year-old insulin-dependent diabetic, who developed a leaking aneurysm of the thoracic aorta as a late complication of a knee empyema with subsequent metastatic mediastinitis. Clinical, radiological, biochemical and microbiological data are correlated with histopathological findings. The development of this unusual thoracic aortic aneurysm is shown from impending rupture to successful vascular graft implantation.
Insights
Infectious thoracic aortic aneurysms are rare. This case highlights a leaking thoracic aortic aneurysm in a diabetic patient, a late complication of knee empyema and mediastinitis, successfully treated with vascular graft implantation.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- Thoracic aortic aneurysms (TAAs) have a broad range of causes.
- Infectious aneurysms, previously termed mycotic aneurysms, are uncommon, typically small, and often arise from bacterial endocarditis.
Observation:
- A 39-year-old insulin-dependent diabetic presented with a leaking thoracic aortic aneurysm.
- This developed as a late complication following a knee empyema and subsequent metastatic mediastinitis.
Findings:
- The case details clinical, radiological, biochemical, and microbiological data.
- Histopathological findings correlate with the observed clinical course.
- The progression from impending rupture to successful surgical intervention is documented.
Implications:
- This case expands the known etiological spectrum of thoracic aortic aneurysms.
- It underscores the potential for late, severe complications from seemingly resolved infections.
- Highlights the importance of considering infectious etiologies in aortic pathology, even in unusual presentations.