title: [Hypertrophic osteoarthropathy and aortic graft infection: Two cases].
abstract: BACKGROUND
  Hypertrophic osteoarthropathy (HOA) located to lower extremities may be the initial manifestation of an infected aortic graft.
  
  
  METHODS
  We report two patients with HOA secondary to aortobifemoral vascular prosthesis infection and aortoenteric fistula. As reported in the literature, initial manifestations included fever, painful swelling of limbs, joint pain, clubbing and in one case intestinal bleeding. These symptoms preceded frank episodes of septicaemia due to a wide variety of bacteria (microbial enteric flora). Bone scan was an appropriate tool for confirming the diagnosis of HOA. Abdominal computed tomography, and PET-scan were useful for detecting vascular infection. Aortoenteric fistula remained difficult to identify.
  
  
  CONCLUSIONS
  Mechanisms involved in the pathogenesis of HOA associated with infected graft are poorly understood, but vascular endothelial growth factor (VEGF) could play a major role. The mortality of infected aortic grafts remains high, but knowledge of this association could lead to early diagnosis and accurate treatment.
authors.affiliation: Service de médecine interne, hôpital Nord, 42055 Saint-Étienne cedex 2, France.
authors.forename: Q
authors.initials: Q
authors.lastname: Lacoin
authors.forename: J-B
authors.initials: JB
authors.lastname: Gaultier
authors.forename: S
authors.initials: S
authors.lastname: Charmion
authors.forename: I
authors.initials: I
authors.lastname: Guichard
authors.forename: P
authors.initials: P
authors.lastname: Cathébras
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000209:etiology*; D011093:Polyethylene Terephthalates; D016459:Prosthesis-Related Infections / Q000150:complications*
chemical_list: D011093:Polyethylene Terephthalates