[Infectious aortitis caused by Streptococcus pneumoniae]

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Pathology

Background:

• Infectious aortitis is a rare condition, often presenting as an aortic aneurysm.
• Common causes include Salmonella and Staphylococcus species, typically leading to acute symptoms.
• Syphilitic and tubercular forms may present subacutely.

Observation:

• A 75-year-old presented with sudden abdominal pain and fever.
• Angio-computed tomography revealed an infrarenal abdominal aortic aneurysm with inflammatory changes and hematoma.
• The patient underwent surgical aortic replacement due to impending rupture.

Findings:

• Blood cultures and aortic wall analysis identified Streptococcus pneumoniae.
• Histopathology showed fibrin clot and leukocyte remodeling of the aortic wall.
• This case adds to the 36 previously reported instances of infectious aortitis in the literature.

Implications:

• Streptococcus pneumoniae is an uncommon but significant cause of infectious aortitis.
• Prompt diagnosis and surgical intervention are crucial for impending aortic rupture.
• Intravenous antibiotic therapy is indicated following diagnosis.