Fatal Salmonella-Infected Aneurysm of the Aortic Arch: A Case Report

非傷寒性沙門氏桿菌感染之致命性主動脈弓血管瘤：病例報告

楊福雄(Fu-Hsiung Yang) ； 簡志峰(Chih-Feng Chian) ； 彭萬誠(Wann-Cherng Perng) ； 吳世偉(Shih-Wei Wu)

《胸腔醫學》 32卷3期 (2017/06) Pp. 136-141

摘要

An infected arterial aneurysm is often caused by Staphylococcus aureus or Salmonella species, and involvement of the aorta is a rare but life-threatening condition. The mortality rate is very high in those without surgical treatment. The typical presentation of an infected aneurysm is based on its location, whether it is in a superficial location (e.g., common femoral artery, a painful, pulsatile mass with fever) or is a deeper vessel (e.g., aorta, fever with or without blood-tinged sputum). Because of the insidious onset, symptoms and signs could occur after rupture of the aneurysm. Here, we describe a fatal case of infected aneurysm of the aortic arch mimicking pneumonia and caused by Salmonella group D.

關鍵字

infected aneurysm of the aortic arch ； Salmonella

並列摘要

感染性動脈瘤(infected aneurysm) 常是由金黃色葡萄球菌(Staphylococcus aureus) 或非傷寒沙門氏桿菌屬(Salmonella species) 所引起的感染性血管瘤。其中的主動脈血管瘤是罕見且常致命的併發症，症狀以非特異性的胸痛、血痰、發燒來表現，甚至有些直到血管瘤破裂才發現，故死亡率很高，尤其是未作外科治療者死亡率更高。因此，即時的診斷與處置相當重要。我們的案例報告是一位59 歲男性，有糖尿病及高血壓病史，因發燒和咳嗽帶有血絲痰至本院急診室求治，經影像學評估可能是感染性主動脈瘤，住院後給予廣效型抗生素治療及會診心血管外科醫師做手術治療的評估；但是不久之後突然心臟停止，經過急救後，病人仍然死亡。死亡後其生前所作之血液培養長出沙門氏桿菌(Salmonella group D)。

並列關鍵字

感染性主動脈弓血管瘤 ； 非傷寒性沙門氏桿菌