Air in the aortic wall: A rare case of Clostridium septicum aortitis
An 81-year-old male presented to the emergency department with a 48-h history of central chest pain radiating to the back. Observations revealed hypoxia, tachycardia, and hypotension. Biochemistry revealed raised inflammatory markers (white cell count: 18.5 × 109/L and C-reactive protein: 62.5 mg/L)...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Vascular and Endovascular Surgery |
| Subjects: | |
| Online Access: | http://www.indjvascsurg.org/article.asp?issn=0972-0820;year=2021;volume=8;issue=2;spage=167;epage=168;aulast=Pradhan |
| Summary: | An 81-year-old male presented to the emergency department with a 48-h history of central chest pain radiating to the back. Observations revealed hypoxia, tachycardia, and hypotension. Biochemistry revealed raised inflammatory markers (white cell count: 18.5 × 109/L and C-reactive protein: 62.5 mg/L) and reduced renal function (creatinine: 157 μmol/L and urea 10.2 mmol/L). Computed tomographic (CT) scan (CT aortogram) revealed the presence of air in a diseased thoracic and abdominal aorta wall with no evidence of aneurysm (A, B, and C). Wall thickening at the cecal pole was noted as well (D). A diagnosis of acute aortitis was made, and the patient was started on intravenous antibiotics. Blood cultures isolated Clostridium septicum. Follow-up CT aortogram performed at 2 weeks revealed a resolution of the pockets of air. Colonoscopy revealed the presence of a fungating cecal mass (adenocarcinoma) as a source of bacteremia leading to aortitis; further, staging identified the disease as nonresectable. |
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| ISSN: | 0972-0820 2394-0999 |