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Surgery
Infectious aortitis and managing it at a community military hospital
  1. Kelly Tang,
  2. Brandon Ford,
  3. Samuel L Grasso and
  4. Jonathan Swisher
  1. General Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA
  1. Correspondence to Dr Samuel L Grasso; samuel.l.grasso{at}gmail.com

Abstract

Infectious aortitis is a rare disease process which can be of fungal, viral or bacterial aetiology. This disease process is often incidentally found during concomitant infectious processes, likely due to haematogenous spread. Common sources are from cardiac, genitourinary and gastroenterologic sources. CT imaging of the aorta is essential in identifying physiological changes—wall thickness changes, ectasia and stenosis. We present a case of a female in her early 60s with a medical history of cardiomyopathy with heart failure and reduced ejection fraction, who was initially admitted for acute cholecystitis complicated by the development of gallstone pancreatitis. Imaging evaluation incidentally noted findings consistent with aortitis with a penetrating ulcer, and blood cultures were positive for Staphylococcus aureus bacteraemia, confirming her diagnosis of infectious aortitis. She was started on intravenous antibiotics, required preoperative nutritional optimisation, and subsequently underwent an open aortic resection and aortoiliac reconstruction with rifampin-soaked Dacron graft.

  • Cardiovascular medicine
  • Intensive care
  • Vasculitis
  • Vascular surgery

https://doi.org/10.1136/bcr-2023-257509

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: KT, literature review and manuscript draft (background, case presentation, learning points); BF, literature review and manuscript draft (summary, discussion and conclusion); SLG, editing of clinical images and critical revision for important intellectual content; JS, clinician in charge of the clinical care of the patient, supervised the preparation of the manuscript, review of investigation results and critical revision. The following authors gave final approval of the manuscript: KT, BF, SLG, JS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.