Infectious Aortitis: Case Report and Literature Review

Abstract

Aortitis is the inflammation of the aorta secondary to either infectious or non-infectious etiologies. Infectious aortitis is a rare but potentially life-threatening condition. It is more common among older patients with preexisting pathology. Clinical presentation is variable, therefore, a high index of suspicion is required for timely diagnosis and management. We report a case of aortitis which was complicated with the development of a saccular abdominal aortic aneurysm. A 76-year-old male presented to the Emergency Department with two days of right lower quadrant abdominal pain. Clinical evaluation and imaging studies revealed abdominal aortitis, which progressed to a saccular abdominal aortic aneurysm. We highlight a unique presentation of infectious aortitis to raise awareness among physicians. We also reviewed the available literature on infectious aortitis to illustrate the importance of early diagnosis and appropriate treatment to improve the patients' outcomes.

Keywords: aneurysm; aortitis; case report; infection; literature review.

Figure 1. Computed tomography scan of the abdomen and pelvic at admission.

A:  Mass in the cecum (green arrow) extending to the appendix and the ileocecal junction with severe adjacent inflammatory changes B:  Acute inflammatory changes were observed in the proximal abdominal aorta

Figure 2. Computed tomography angiography of the abdomen showed mid abdominal aortitis

Figure 3. Computed tomography scan of the abdomen and pelvic

Computed tomography scan of the abdomen and pelvic at hospital day six showed a new around 4 x 3 cm saccular aortic aneurysm from the left aspect of the proximal abdominal aorta. A: Axial section. B: Coronal section

Figure 4. Magnetic resonance imaging revealed a mycotic abdominal aortic aneurysm