[Rupture of mycotic arch aneurysm with rapid enlargement].
An 85-year-old woman was admitted to the hospital for a lumbar compression fracture. Her white blood cells and C-reactive protein (CRP) were elevated to 20,400/microl and 30.58 mg/dl, respectively. Chest and back pain occurred suddenly, 16 days after admission. Computed tomography revealed aortic arch aneurysm and bleeding. Rupture of the aortic arch aneurysm was diagnosed and she was transferred to our hospital for an emergency operation. The aneurysm was treated by debridement of the infected aortic tissue, and total aortic arch replacement was performed. Bacterial culture of the aneurysmal wall demonstrated methicillin sensitive Staphylococcus aureus (MSSA). Her postoperative course was uneventful. After surgery, antibiotics were administered for 2 weeks intravenously and orally. However oral antibiotics were administered again for about 2 months because wound infection occurred on the day 37 and 60 postoperatively. CRP normalized during her course of antibiotic therapy. Thereafter, the patient remained well without any sign of wound infection or mediastinitis.
Department of Cardiovascular Surgery, Yamanashi Prefectural Central Hospital, Kofu, Japan.
Yuki
Y
Okamoto
K
K
Tsuchiya
M
M
Nakajima
K
K
Yano
T
T
Kobayashi
D000208:Acute Disease; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D016106:Methicillin Resistance; D013902:Radiography, Thoracic; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents