PDF(Pubmed)
Abstract：
We describe the case of a 68-year-old man who underwent ascending aortic replacement and thoracic endovascular aortic repair. Four years later, the patient developed neck pain on the right side and chest computed tomography showed expansion of fluid in the mediastinum which had extended to the neck. Echocardiography revealed advanced severity of aortic regurgitation and decreased ejection fraction. Given the progression of aortic regurgitation, decreased cardiac function, and rapidly expanding fluid accumulation causing neck pain, reoperation was indicated. All microbiological test including polymerase chain reaction were negative indicating absence of any infection. The patient is being followed-up without antibiotics and CT has not shown peri-graft fluid 2 years postoperatively. Since infection cannot be excluded completely, it is important to assess the condition with selective medium, extended culture periods, genetic testing, and consultations with microbiology laboratories when normal culture tests for general bacteria, and fungi are negative which can help avoid drug-resistant bacteria count, elevated medical costs, and drug side effects due to the improper use of antibiotics through proper diagnosis.
摘要：
我们描述了一名68岁的男子接受了升主动脉置换和胸主动脉腔内修复术的情况。四年后,患者右侧出现颈部疼痛，胸部计算机断层扫描显示纵隔液体扩张并延伸至颈部。超声心动图显示主动脉瓣返流严重程度晚期，射血分数降低。鉴于主动脉瓣反流的进展，心功能下降，迅速膨胀的液体积聚导致颈部疼痛，表示再次手术。包括聚合酶链反应在内的所有微生物测试均为阴性，表明没有任何感染。该患者正在接受无抗生素随访，术后2年CT未显示移植物周围积液。因为感染不能完全排除,重要的是用选择性培养基评估条件，延长文化时期，基因检测,并在进行普通细菌的正常培养测试时与微生物学实验室进行磋商，真菌呈阴性，这有助于避免耐药细菌计数，医疗费用上涨,和药物副作用由于不当使用抗生素通过适当的诊断。
