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World Journal of Emergency Medicine ›› 2013, Vol. 4 ›› Issue (2): 154-156.doi: 10.5847/wjem.j.issn.1920-8642.2013.02.013

• Case Reports • Previous Articles    

Staphylococcal thoracic aortitis complicated by aortic dissection

Paul Chun Yih Lim1(), Jean Mui Hua Lee2, Yeow Leng Chua1, Stanley Chia1   

  1. 1National Heart Centre Singapore, Mistri Wing, 168752, Singapore
    2Department of Emergency Medicine, Singapore General Hospital, 169608, Singapore
  • Received:2012-12-19 Accepted:2013-04-02 Online:2013-06-15 Published:2013-06-15
  • Contact: Paul Chun Yih Lim E-mail:paul.lim.c.y@nhcs.com.sg

Abstract:

BACKGROUND: The diagnosis of aortitis is often delayed as symptoms are largely non-specific. We report a case of Staphylococcal thoracic aortitis in a 73-year-old Chinese woman complicated by aortic dissection.
METHODS: The patient presented with pyrexia of unknown origin, and a contrast enhanced computed tomography aortogram revealed a large thrombus at the anterior aspect of the ascending aorta with two large ulcerations as a result of a chronic type A aortic dissection. A hemiarch replacement with a 28 mm Gleweave Vascutek graft was performed with resuspension of aortic valve commisures. Aortic thrombus cultures were positive for coagulase negativeStaphylococcus aureaus, and histology showed chronic dissection of the aorta.
RESULTS: The patient was treated with intravenous cefazolin for a 6-week duration and made good progress.
CONCLUSIONS: This case highlights Staphylococcal infective aortitis complicated by dissection presenting as fever of unknown origin. Timely diagnosis is essential as progression to catastrophic rupture may occur.

Key words: Aneurysm, Aortic diseases, Endovascular stent, Infected/microbiology, Staphalococcus aureus