Abstract
BackgroundThoracic aortitis caused by Clostridium septicum is a rare infection with a strong association with malignancy and high mortality rate when left untreated. We report a case of surgical treatment for Stanford type A acute aortic dissection in a patient with C. septicum sepsis and thoracic aortitis.Case presentationA 63-year-old hypertensive man with rheumatoid arthritis presented with general malaise and diagnosed with C. septicum-infected aortitis with sepsis. On the 5th day of hospitalization, Stanford type A acute aortic dissection developed with severe aortic regurgitation. The patient underwent emergent surgical treatment successfully with excision of the infected ascending aorta and aortic root followed by replacement using a composite graft, followed by diagnosis of sigmoid colon cancer 7 months after aortic surgery. He was scheduled to undergo elective colon surgery.ConclusionsC. septicum aortitis can progress quickly, causing aneurysm or dissection. Therefore, in a patient with C. septicum aortitis, prompt surgical in situ graft replacement should be performed to debride the infected vascular lesions. Further investigations for gastrointestinal and hematological malignancies as a source of C. septicum should be also conducted.
Highlights
Clostridium septicum is an anaerobic, gram-positive bacillus to withstand a variety of environments
We present a rare case of C. septicum-infected aortitis causing Stanford type A acute aortic dissection with sepsis, treated successfully with excision of the infected ascending aorta and aortic root followed by replacement with a composite graft
Seven months after surgery when we obtain the informed consent for the endoscopy, he was diagnosed with sigmoid colon cancer and scheduled to undergo elective colon surgery
Summary
C. septicum aortitis can progress quickly, causing aneurysm or dissection. In a patient with C. septicum aortitis, prompt surgical in situ graft replacement should be performed to debride the infected vascular lesions. Further investigations for gastrointestinal and hematological malignancies as a source of C. septicum should be conducted
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