细菌,尤其是葡萄球菌组,导致主动脉移植物感染。感染源于修复动脉瘤或动脉阻塞的合成材料。主动脉支架感染和植被形成很少见,在常规诊断方式中,异质性的表现和模棱两可的发现使诊断具有挑战性。一名25岁的男性,有导管主动脉支架置入术治疗严重主动脉缩窄相关高血压的病史,被转诊到我们的三级护理医院。演讲前五个月,患者已感染COVID-19,但症状轻微后康复。然而,3个月后,他出现了红斑性病变,进行性厌食症,上腹痛,发烧,和弱点。血液检查的结果,血培养,经胸超声心动图,胸部X线平片,计算机断层扫描血管造影,心电图无异常。我们发现了严重的感染性主动脉炎,主动脉周围的新月形厚度,假性动脉瘤的发展,经食管超声心动图(TEE)检查主动脉支架内大小为17mm×8mm的肿块。开始广谱抗生素治疗,病人被转移到手术室,被感染的支架和粘附性植被被移除。手术后患者恢复明显,出院。在6个月的随访中,他身体状况良好。我们的发现强调了保持警惕和临床高度怀疑植被形成和主动脉炎作为COVID-19可能后遗症的重要性,特别是在植入支架的患者中。此外,我们强烈建议TEE植入支架的患者用于检测植被和主动脉炎。
Bacteria, especially staphylococcal groups, cause aortic graft infection. Infection stems from synthetic materials that repair aneurysms or artery blockages. Aortic stent infection and vegetation formation are rare, and heterogeneous presentations and ambiguous findings in routine diagnostic modalities render the diagnosis challenging. A 25-year-old man with a history of catheter-based aortic stenting for hypertension associated with severe aortic coarctation was referred to our tertiary care hospital. Five months before the presentation, the patient had been infected with COVID-19, but he recovered after mild symptoms. Nevertheless, 3 months later, he developed erythematous lesions, progressive anorexia, epigastric pain, fever, and weakness. The results of blood tests, blood cultures, transthoracic echocardiography, plain chest radiography, computed tomography angiography, and electrocardiography were unremarkable. We found severe infectious
aortitis, crescent thickness surrounding the aorta, pseudoaneurysm development, and a mass with dimensions of 17 mm×8 mm within the aortic stent on transesophageal echocardiography (TEE). Broad-spectrum antibiotic therapy was initiated, and the patient was transferred to the operating room, where the infected stent and adhesive vegetation were removed. The patient recovered remarkably after the surgery and was discharged. At 6 months\' follow-up, he was in good condition. Our findings highlight the significance of maintaining vigilance and a high level of clinical suspicion for the possibility of vegetation formation and
aortitis as the possible sequelae of COVID-19, particularly in patients with an implanted stent. Furthermore, we strongly suggest TEE in patients with implanted stents to detect vegetation and
aortitis.