Related Experiment Videos
[Infectious arteriopathies]
Abstract:
After reviewing the physiopathology, the authors report the principal features of infectious arterial disease observed in a department of infectious diseases. Excluding iatrogenic arteritis, particularly after vascular surgery, and some vasculitis in which an infectious agent may play a role, only the classical but now rare causes are described: rickettsial disease, syphilis and typhoid. The most commonly observed problem at present is infectious aneurysms: primary aneurysms secondary to atherosclerosis in which salmonella is by far the predominant organism, before the staphylococci and streptococci. The most serious complication is the major risk of rupture which may be the presenting event. Secondary aneurysms are essentially those of endocarditis. The mechanism is not fully understood and they occur at different stages of the course of the disease. The main problem associated with these aneurysms is their multiplicity and localisation; the intracranial forms are the most common and most serious in the experience of the authors, with their difficulties of diagnosis and treatment: extracranial aneurysms are usually located in the main limb arteries. Adjacent secondary aneurysms are exceptionally rare. Tuberculous and viral causes of aneurysm are among the rarest etiologies discussed.
Insights
Infectious arterial diseases, particularly infectious aneurysms caused by Salmonella, pose a significant rupture risk. Intracranial aneurysms present diagnostic and treatment challenges.
Area of Science:
- Vascular Medicine
- Infectious Diseases
Background:
- Infectious arterial disease encompasses various etiologies, including rare classical causes like syphilis and typhoid.
- Iatrogenic arteritis and some vasculitides with potential infectious links are excluded from this review.
Observation:
- Infectious aneurysms are the most common presentation, with Salmonella being the predominant pathogen in primary aneurysms secondary to atherosclerosis.
- Staphylococci and streptococci are less common causes of infectious aneurysms.
- Secondary aneurysms associated with endocarditis are noted, characterized by multiplicity and challenging localization, especially intracranial forms.
Findings:
- The primary risk associated with infectious aneurysms is rupture, which can be the initial clinical manifestation.
- Intracranial infectious aneurysms are the most frequent and severe, posing diagnostic and therapeutic difficulties.
- Extracranial aneurysms typically affect major limb arteries.
Implications:
- Understanding the prevalence and causative agents of infectious aneurysms is crucial for timely diagnosis and management.
- The high risk of rupture underscores the need for prompt intervention in suspected cases of infectious arterial disease.
- Further research into the mechanisms and treatment of endocarditis-related aneurysms, particularly intracranial ones, is warranted.