Aortic rupture from MSSA aortitis in a healthy 21-year-old: a case report

Infectious aortitis is a rare disease affecting predominantly older individuals with pre-existing conditions. We report an unusual case of a healthy, athletic 21-year old male, who developed extensive aortitis with consecutive aortic rupture.

A 21-year old male reported to the emergency department of a local hospital with persisting symptoms of a respiratory tract infection. After admission and initial antibiotic therapy symptoms aggravated and the patient presented with staphylococcus aureus (methicillin-susceptible, MSSA) bacteraemia and a pericardial effusion. After the operative drainage, a routine CT-scan showed a rupture of the aortic arch. The patient was transferred to our hospital and operated. Histopathological analysis of resected aortic tissue showed a phlegmonous inflammation of the aortic wall with the proof of MSSA. The patient recovered completely and was discharged after 22 days.

A case of infectious aortitis in a young individual without any pre-existing condition or pathology of the aorta is extremely uncommon and unlikely. The clinical diagnosis of aortitis is difficult due to its unspecific presentation. Predisposing factors like age, pre-existing conditions, pathologies of the aorta and immunosuppression are described in literature and can help to raise suspicion. This unique case shows infectious aortitis can develop even in the absence of all described risk factors.