Abstract
IntroductionInfective aortitis has become uncommon since the advent of antibiotic therapy. Aortitis, presenting as a localised perforation in a non-aneurysmal aorta, is extremely rare. We report the case of an 82-year-old woman who was diagnosed with localised perforation of a non-aneurysmal abdominal aorta secondary to staphylococcus aortitis.Case presentationAn 82-year-old woman presented with a history of a sudden onset of back pain and pyrexia. A clinical examination did not reveal any significant findings attributable to her sepsis. As her clinical condition deteriorated rapidly, adequate resuscitation was commenced. Appropriate serology and radiological investigations, including a computed tomography scan, were performed. The computed tomography scan revealed a diagnosis of a non-aneurysmal infective abdominal aortitis with evidence of localised perforation. This was successfully treated under local anaesthetic with endovascular aortic repair and appropriate antibiotics. She recovered fully and was completely asymptomatic a year later.ConclusionA detailed assessment is essential in the diagnosis of this condition as it can frequently be missed on initial evaluation of the affected patient. Clinical features are often nonspecific and can include fever, leucocytosis and bacteremia in the absence of a pulsatile or expansile mass. The patient may also complain of back pain, as in this case report. Thorough assessment, timely investigation and endovascular intervention prevented a potentially fatal condition in our patient.
Highlights
Infective aortitis has become uncommon since the advent of antibiotic therapy
The computed tomography scan revealed a diagnosis of a non-aneurysmal infective abdominal aortitis with evidence of localised perforation
A detailed assessment is essential in the diagnosis of this condition as it can frequently be missed on initial evaluation of the affected patient
Summary
Most reports of endovascular treatment of inflammatory aneurysms have been performed under general anaesthetic or spinal anaesthetic. Treatment options for this patient were limited because of the high operative risk under a general or spinal anaesthetic. A thorough assessment and early radiological investigations ensured a timely diagnosis and appropriate intervention in this case. Nonspecific clinical features of this condition can result in a delay in diagnosis with a potential fatal outcome. Abbreviations CT, computed tomography; EVAR, endovascular aortic repair; IAAA, inflammatory aneurysm of the abdominal aorta. Consent Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests
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