背景:沙门氏菌。通过肠道沙门氏菌感染的血行传播引起感染性主动脉炎。沙门氏菌主动脉炎可导致主动脉广泛的组织损伤,导致包括夹层在内的并发症。脓肿形成,假性动脉瘤,和破裂,这需要早期诊断和手术和抗生素治疗。
方法:报告1例沙门菌主动脉炎合并StanfordA型主动脉夹层。一名有海洛因使用史的62岁男子出现胸痛,上腹痛和呕吐。计算机断层扫描显示StanfordA型主动脉夹层,无灌注不良。在手术的时候,在升主动脉中发现有化脓液和破裂的主动脉夹层。液体培养与沙门氏菌一致。进行了具有升主动脉和半弓置换的复合瓣膜移植物导管主动脉根置换。患者恢复良好,长期服用抗生素后出院。
结论:这种罕见的StanfordA型主动脉夹层因沙门氏菌主动脉炎引起的破裂,通过紧急手术和抗生素治疗成功治疗。
BACKGROUND: Salmonella spp. cause infectious aortitis through the hematogenous spread of an intestinal Salmonella infection. Salmonella aortitis can result in extensive tissue damage in the aorta leading to complications including dissection, abscess formation, pseudoaneurysms, and rupture, which require early diagnosis and treatment with both surgery and antibiotic therapy.
METHODS: We report a case of Salmonella aortitis complicated by Stanford type A aortic dissection. A 62-year-old man with a history of heroin use presented with chest pain, epigastric pain and vomiting. The computed tomography scan showed Stanford type A aortic dissection without malperfusion. At the time of surgery, an aortic dissection with purulent fluid and contained rupture was noted in the ascending aorta. Fluid culture was consistent with Salmonella. A composite valve-graft conduit aortic root replacement with ascending aorta and hemiarch replacement was performed. The patient recovered well and was discharged on long-term antibiotics.
CONCLUSIONS: This rare case of a Stanford type A aortic dissection with contained rupture due to Salmonella aortitis was successfully treated with emergent surgery and antibiotic therapy.