The Japanese Journal of Thoracic Surgery Volume 71, Issue 12 (November 2018)

Infected Thoracic Aortic Aneurysm Secondary to the Purulent Pericarditis;Report of a Case Kenji Matsuzaki 1 , Ko Takigami 1 , Hiroshi Matsuura 1 , Masato Kuzume 1 , Sanae Hamaguchi 1 , Kazuyuki Noriyasu 1 , Nozomu Kawashima 1 , Noriyuki Miyamoto 1 1Department of Cardiovascular Surgery, NTT Higashi Nihon Sapporo Hospital Keyword: purulent pericarditis , infected aneurysm , thoracic endovascular aneurysm repair pp.1023-1026
Published Date 2018/11/1
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A 69-year-old man was hospitalized urgently to the department of cardiology, with the progressive general malaise. On admission, his blood pressure was 80/42 mmHg, his white cell count 13,700/μl, and C-reactive protein 25.55 mg/dl suggesting existence of aggressive infection with impaired circulation. Massive pericardial effusion was detected in echocardiography. Pericardial drainage was undergone promptly. There was drainage of 700 ml and the property was purulent. Pneumococcus was detected by the culture test of the pericardial fluid. Antibiotic administration was started by a diagnosis of the purulent pericarditis. His general condition was improved. However, a rapidly expanding saccular aneurysm was found in a descending thoracic aorta by computed tomography (CT). As an infected thoracic aortic aneurysm secondary to the purulent pericarditis, we performed thoracic endovascular aneurysm repair (TEVAR). The intravenous administration of antibiotics was continued for 2 weeks after TEVAR, which was followed by oral antibiotic administration for 1 year. The aneurysm completely disappeared by CT, 10 months after TEVAR. In case with an infected thoracic aortic aneurysm, TEVAR can be a 1st choice of treatment, depending on a causative organism and the morphology of the aneurysm.

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71巻12号 (2018年11月)
電子版ISSN 2432-9436 印刷版ISSN 0021-5252 南江堂