Abstract：
BACKGROUND: It is challenging to diagnose infected aneurysm in the early phase. This study aimed to describe the clinical and microbiological characteristics of infected aneurysm, and to elucidate the difficulties in diagnosing the disease.
METHODS: Forty-one cases of infected aneurysm were diagnosed in Nagasaki University Hospital from 2005 to 2019. Information on clinical and microbiological characteristics, radiological findings, duration of onset, and type of initial computed tomography (CT) imaging conditions were collected. Factors related to diagnostic delay were analyzed by Fisher\'s exact test for categorical variables or by the Wilcoxon rank-sum test for continuous variables.
RESULTS: Pathogens were identified in 34 of 41 cases; the pathogens were Gram-positive cocci in 16 cases, Gram-negative rods in 13 cases, and others in five cases. Clinical characteristics did not differ in accordance with the identified bacteria. At the time of admission, 16 patients were given different initial diagnoses, of which acute pyelonephritis (n = 5) was the most frequent. Compared with the 22 patients with an accurate initial diagnosis, the 19 initially misdiagnosed patients were more likely to have been examined by plain CT. The sensitivities of plain CT and contrast-enhanced CT were 38.1% and 80.0%, respectively.
CONCLUSIONS: In cases of infected aneurysm, diagnostic delay is attributed to non-specific symptoms and the low sensitivity of plain CT. Clinical characteristics of infected aneurysm mimic various diseases. Contrast-enhanced CT should be considered if infected aneurysm is suspected.
METHODS: Forty-one cases of infected aneurysm were diagnosed in Nagasaki University Hospital from 2005 to 2019. Information on clinical and microbiological characteristics, radiological findings, duration of onset, and type of initial computed tomography (CT) imaging conditions were collected. Factors related to diagnostic delay were analyzed by Fisher\'s exact test for categorical variables or by the Wilcoxon rank-sum test for continuous variables.
RESULTS: Pathogens were identified in 34 of 41 cases; the pathogens were Gram-positive cocci in 16 cases, Gram-negative rods in 13 cases, and others in five cases. Clinical characteristics did not differ in accordance with the identified bacteria. At the time of admission, 16 patients were given different initial diagnoses, of which acute pyelonephritis (n = 5) was the most frequent. Compared with the 22 patients with an accurate initial diagnosis, the 19 initially misdiagnosed patients were more likely to have been examined by plain CT. The sensitivities of plain CT and contrast-enhanced CT were 38.1% and 80.0%, respectively.
CONCLUSIONS: In cases of infected aneurysm, diagnostic delay is attributed to non-specific symptoms and the low sensitivity of plain CT. Clinical characteristics of infected aneurysm mimic various diseases. Contrast-enhanced CT should be considered if infected aneurysm is suspected.
摘要：
背景：在早期阶段诊断感染的动脉瘤具有挑战性。本研究旨在描述感染动脉瘤的临床和微生物学特征，并阐明诊断疾病的困难。
方法：长崎大学附属医院2005-2019年诊断为感染性动脉瘤41例。关于临床和微生物学特征的信息，放射学发现，发病持续时间,收集初始计算机断层扫描（CT）成像条件的类型。通过分类变量的Fisher精确检验或连续变量的Wilcoxon秩和检验分析与诊断延迟相关的因素。
结果:41例中有34例病原菌,16例革兰阳性球菌,革兰氏阴性棒13例，和其他人在五个案例中。根据鉴定的细菌，临床特征没有差异。在录取的时候,16例患者接受了不同的初步诊断，其中急性肾盂肾炎（n=5）最常见。与初步诊断准确的22例患者相比，19例最初误诊的患者更有可能接受普通CT检查。平扫CT和增强CT的敏感性分别为38.1%和80.0%,分别。
结论：在感染动脉瘤的病例中，诊断延迟归因于非特异性症状和普通CT的敏感性低。感染动脉瘤模拟各种疾病的临床特征。如果怀疑动脉瘤感染，应考虑使用CT造影。
方法：长崎大学附属医院2005-2019年诊断为感染性动脉瘤41例。关于临床和微生物学特征的信息，放射学发现，发病持续时间,收集初始计算机断层扫描（CT）成像条件的类型。通过分类变量的Fisher精确检验或连续变量的Wilcoxon秩和检验分析与诊断延迟相关的因素。
结果:41例中有34例病原菌,16例革兰阳性球菌,革兰氏阴性棒13例，和其他人在五个案例中。根据鉴定的细菌，临床特征没有差异。在录取的时候,16例患者接受了不同的初步诊断，其中急性肾盂肾炎（n=5）最常见。与初步诊断准确的22例患者相比，19例最初误诊的患者更有可能接受普通CT检查。平扫CT和增强CT的敏感性分别为38.1%和80.0%,分别。
结论：在感染动脉瘤的病例中，诊断延迟归因于非特异性症状和普通CT的敏感性低。感染动脉瘤模拟各种疾病的临床特征。如果怀疑动脉瘤感染，应考虑使用CT造影。
