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Infected Aortic Aneurysm Mimicking Anti-proteinase 3-Antineutrophil Cytoplasmic Antibody-associated Vasculitis

Kenta Hachiya1, Kazuaki Wakami, Atsuhiro Yoshida

  • 1Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan.

Internal Medicine (Tokyo, Japan)
|December 2, 2016
PubMed

Insights

This case highlights an infected descending aortic pseudoaneurysm mimicking vasculitis. Prompt diagnosis and treatment with antibiotics and endovascular repair were crucial for successful patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Descending aortic pseudoaneurysms can present with complex clinical scenarios.
  • Distinguishing infectious etiologies from inflammatory conditions like vasculitis is clinically challenging.
  • Anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis shares some overlapping features with infectious aortic pathologies.

Observation:

  • A patient presented with clinical and serological findings suggestive of anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis.
  • Imaging revealed a descending aortic pseudoaneurysm with pathognomonic oscillating vegetations.
  • Positive blood cultures confirmed an infectious etiology.

Findings:

  • The patient was diagnosed with an infected descending aortic pseudoaneurysm.
  • The condition mimicked anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis.
  • Successful treatment involved antibiotics and endovascular aortic repair.

Implications:

  • Accurate diagnosis is critical to prevent inappropriate immunosuppressive therapy in infected aortic aneurysms.
  • Infected aortic aneurysms require prompt antimicrobial and potentially surgical intervention.
  • This case underscores the importance of considering infectious causes in aortic pathologies presenting with vasculitic features.

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