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Pneumococcal aortitis: a difficult preoperative diagnosis.

Wang Teng1, Mark R Sarfati, Michelle T Mueller

  • 1Division of Vascular Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA.

Journal of Vascular Surgery
|January 18, 2006
PubMed
Summary
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Primary aortic infections are rare. A pneumococcal mycotic aneurysm, initially misdiagnosed as noninfectious aortitis, highlights the challenge of differentiating these conditions and the importance of aortic surveillance.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Cardiology

Background:

  • Primary infections of the aorta are uncommon and can be challenging to diagnose.
  • Distinguishing between microbial aortitis and noninfectious chronic periaortitis is clinically significant.

Observation:

  • A patient initially diagnosed with noninfectious aortitis following an extensive work-up experienced clinical deterioration.
  • Surgical intervention revealed a pneumococcal mycotic aneurysm, indicating a primary aortic infection.

Findings:

  • The case underscores the diagnostic difficulties in differentiating microbial aortitis from noninfectious chronic periaortitis.
  • Immunosuppressive therapy for noninfectious aortitis may necessitate vigilant surveillance imaging due to potential for misdiagnosis.

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Implications:

  • Accurate differentiation between infectious and non-infectious aortitis is crucial for appropriate patient management.
  • Close aortic surveillance is recommended for patients treated with immunosuppression for suspected noninfectious aortitis.
  • Surgical repair of the infected aortoiliac segment was successfully achieved using autologous femoral veins.