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[Association of infectious aneurysm and microbial spondylodiscitis: physiopathological hypotheses, diagnostic and
1Service de médecine interne et immunologie clinique, CHRU de Dijon, France.
Abstract:
Two years after a Staphylococcus aureus septicaemia, in a patient with dermatopolymyositis occurred an infectious aneurysm of abdominal aorta with contiguous pyogenic spondylodiscitis. Coexistence of both pathologies is rare and physiopathological mechanisms still remain uncertain. However, many arguments in the present case report are in favour of the initial responsibility of an infectious aneurysm. Main interest in early diagnosing infectious aneurysm, allowed by new investigations such as magnetic resonance imaging and marked leukocyte bone scanning, is the prevention of major complications. Antibiotherapy and surgical removal of infectious aneurysm must be quickly achieved in every case.
Insights
This case report details a rare instance of infectious abdominal aortic aneurysm and spondylodiscitis in a patient with dermatopolymyositis. Early diagnosis and prompt treatment with antibiotics and surgery are crucial for preventing severe complications.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Rheumatology
Background:
- Dermatopolymyositis is an autoimmune disease affecting muscles and skin.
- Staphylococcus aureus septicaemia can lead to severe systemic infections.
- Infectious aneurysms are rare but life-threatening vascular complications.
Observation:
- A patient with dermatopolymyositis developed an infectious aneurysm of the abdominal aorta two years after Staphylococcus aureus septicaemia.
- This was accompanied by contiguous pyogenic spondylodiscitis, a rare co-occurrence.
- The case suggests the infectious aneurysm was the primary pathology.
Findings:
- Advanced imaging like magnetic resonance imaging (MRI) and marked leukocyte bone scanning aids in early diagnosis.
- Prompt diagnosis is key to preventing major complications associated with infectious aneurysms.
- The coexistence of infectious aneurysm and spondylodiscitis is uncommon, with uncertain physiopathological mechanisms.
Implications:
- Highlights the importance of considering infectious aneurysms in patients with relevant risk factors.
- Emphasizes the need for rapid diagnosis and multidisciplinary management, including antibiotherapy and surgical intervention.
- Underscores the potential for severe complications if infectious aneurysms are not promptly addressed.