PDF(Pubmed)
Abstract：
Giant septic pulmonary artery aneurysms (PAAs) are rare but important entities, with few cases having been reported worldwide. Early diagnosis and prompt treatment are crucial in the management of such cases. We report a 56-year-old female patient presenting with fatigue, nausea and vomiting who was first diagnosed with diabetic ketoacidosis (DKA) and developed life-threatening giant infectious PAA secondary to SARS-CoV-2 infection and Actinomyces odontolyticus sepsis. The patient did not develop any specific symptoms, and enhanced computed tomography (CT) revealed a massive PAA of 5.6 × 4.9 cm in size at the left pulmonary hilar with normal pulmonary artery (PA) pressures. After multidisciplinary discussion and after considering the critical condition accompanied by sepsis increased the risk of surgery, endovascular treatment was the first therapy of choice for the patient; nevertheless, the patient ultimately opted for hospice care. This case report aims to raise awareness of PAAs, which are rare but potentially fatal complications of infectious diseases such as COVID-19 pneumonia and Actinomyces odontolyticus sepsis.
摘要：
巨大的化脓性肺动脉动脉瘤（PAA）是罕见但重要的实体，在世界范围内报告的病例很少。早期诊断和及时治疗对于此类病例的管理至关重要。我们报告了一名56岁的女性患者，表现为疲劳，首次诊断为糖尿病酮症酸中毒（DKA）并继发于SARS-CoV-2感染和放线菌败血症的巨大感染性PAA的恶心和呕吐。患者没有出现任何特定症状，增强计算机断层扫描（CT）显示左肺门有5.6×4.9cm的巨大PAA，肺动脉（PA）压力正常。经过多学科的讨论，并考虑到伴有败血症的危重情况增加了手术的风险，血管内治疗是患者的首选治疗方法；尽管如此，患者最终选择了临终关怀。本案例报告旨在提高对PAA的认识，这是感染性疾病如COVID-19肺炎和放线菌败血症的罕见但潜在的致命并发症。
