Mycotic aneurysm with aortoduodenal fistula.

Autor:	Vitturi BK; Santa Casa de São Paulo, Faculdade de Ciências Médicas. São Paulo, SP, Brazil., Frias A; Santa Casa de São Paulo, Faculdade de Ciências Médicas. São Paulo, SP, Brazil., Sementilli R; Santa Casa de São Paulo, Faculdade de Ciências Médicas, Department of Pathology. São Paulo, SP, Brazil., Racy MCJ; Santa Casa de São Paulo, Faculdade de Ciências Médicas, Department of Radiology. São Paulo, SP, Brazil., Caffaro RA; Santa Casa de São Paulo, Faculdade de Ciências Médicas, Department of Vascular Surgery. São Paulo, SP, Brazil., Pozzan G; Santa Casa de São Paulo, Faculdade de Ciências Médicas, Cardiovascular Pathology - Pathological Sciences. São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Autopsy & case reports [Autops Case Rep] 2017 Jun 30; Vol. 7 (2), pp. 27-34. Date of Electronic Publication: 2017 Jun 30 (Print Publication: 2017).
DOI:	10.4322/acr.2017.015
Abstrakt:	Firstly described in the 19th century by Sir William Osler, the mycotic aneurysm (MA) is a rare entity characterized by an abnormal arterial dilation, which is potentially fatal, and is associated with the infection of the vascular wall. Elderly patients are mostly involved, especially when risk factors like chronic diseases, immunosuppression, neoplasia, and arterial manipulation are associated. The authors report the case of a young male patient diagnosed with an aortic aneurysm of infectious origin in the presence of repeated negative blood cultures. The diagnostic hypothesis was raised when the patient was hospitalized for an inguinal hernia surgery. The diagnosis was confirmed based on imaging findings consistent with mycotic aneurism. The patient was treated with an endovascular prosthesis associated with a long-lasting antibiotic therapy. Five months later, the patient attended the emergency unit presenting an upper digestive hemorrhage and shock, from which he died. The autopsy revealed a huge aneurysm of the abdominal aorta with an aortoduodenal fistula. The histological examination of the arterial wall revealed a marked inflammatory process, extensive destruction of the arterial wall, and the presence of Gram-positive bacteria. This case highlights the atypical presentation of a MA associated with an aortoduodenal fistula. Besides the early age of the patient, no primary arterial disease could be found, and no source of infection was detected. Competing Interests: Conflict of interest: None
Databáze:	MEDLINE
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