[Thoracic infectious aortitis: microbiology, pathophysiology and treatment]

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Microbiology

Context:

• Thoracic infectious aortitis, though rare, presents a significant mortality risk if untreated.
• The spectrum of causative microorganisms in infectious aortitis is diverse, with distinct pathophysiological implications.
• Effective management necessitates a multidisciplinary approach integrating medical and surgical interventions.

Purpose:

• To review the current understanding of thoracic infectious aortitis, including its epidemiology, risk factors, and treatment strategies.
• To highlight the evolving bacterial landscape of infectious aortitis, influenced by antibiotic usage.
• To emphasize the critical role of atherosclerosis as a primary risk factor and the importance of its prevention.

Summary:

• Infectious aortitis epidemiology has shifted, with a decline in syphilitic cases and a rise in Staphylococcus aureus and Streptococcus, often linked to infective endocarditis.
• Salmonella species are the most common Gram-negative pathogens implicated.
• Atherosclerosis is identified as the principal risk factor, facilitating bacterial adherence and aneurysm formation.

Impact:

• Understanding these changes is vital for timely and adequate treatment of infectious aortitis.
• Prevention of atherosclerosis is paramount for reducing the incidence and improving outcomes of infectious aortitis.
• Knowledge of diverse microbial causes and their association with conditions like infective endocarditis aids in targeted therapeutic strategies.