Clostridium septicum-infected Stanford type A acute aortic dissection: a case report.
Acute aortic dissection
Clostridium septicum
Thoracic aortitis
Journal
Surgical case reports
ISSN: 2198-7793
Titre abrégé: Surg Case Rep
Pays: Germany
ID NLM: 101662125
Informations de publication
Date de publication:
16 Jan 2020
16 Jan 2020
Historique:
received:
09
08
2019
accepted:
31
12
2019
entrez:
18
1
2020
pubmed:
18
1
2020
medline:
18
1
2020
Statut:
epublish
Résumé
Thoracic 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. A 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. C. 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.
Sections du résumé
BACKGROUND
BACKGROUND
Thoracic 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 PRESENTATION
METHODS
A 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.
CONCLUSIONS
CONCLUSIONS
C. 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.
Identifiants
pubmed: 31950362
doi: 10.1186/s40792-020-0770-y
pii: 10.1186/s40792-020-0770-y
pmc: PMC6965561
doi:
Types de publication
Journal Article
Langues
eng
Pagination
23Références
J Med Case Rep. 2017 Sep 21;11(1):268
pubmed: 28931420
Ann Surg. 1981 Mar;193(3):361-4
pubmed: 7212798
J Clin Med Res. 2016 Feb;8(2):168-74
pubmed: 26767087
JAMA. 1969 Jul 21;209(3):385-8
pubmed: 5819436
Am J Med. 1979 Jan;66(1):63-6
pubmed: 420252
Ann Vasc Surg. 2017 Aug;43:314.e5-314.e11
pubmed: 28479472
JAMA Intern Med. 2015 Nov;175(11):1839-47
pubmed: 26436523