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Thorakales Aortenaneurysma bei metastatischer Mediastinitis

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Zusammenfassung

Das Ursachenspektrum thorakaler Aortenaneurysmen ist breit gefächert; hierbei machen mykotische Aneurysmen prozentual nur einen geringen Anteil aus. Sie sind oft relativ klein und entwickeln sich meist als Komplikationen bakterieller Endokarditiden. Es wird über das Krankheitsbild eines 39-jährigen insulinpflichtigen Diabetikers berichtet, der eine gedeckte thorakale Aortenruptur als Spätfolge eines Kniegelenkempyems mit metastatischer Mediastinitis entwickelte. Anhand klinischer Daten sowie röntgenographischer, klinisch-chemischer und mikrobiologischer Befunde wird die Korrelation zum histopathologischen Erscheinungsbild hergestellt. Entwicklungsverlauf und Befunde dieses ungewöhnlichen thorakalen Aortenaneurysmas werden bis hin zur gedeckten Ruptur und erfolgreichen prothetischen Sanierung dargestellt.

Summary

The aetiological spectrum of thoracic aortic aneurysms is extensive. Infectious aneurysms (formerly mycotic aneurysms) constitute only a small percentage of all thoracic aortic aneurysms, they are usually small and often develop as complications of bacterial endocarditis. We report the case of a 39-year-old insulin-dependent diabetic, who developed a leaking aneurysm of the thoracic aorta as a late complication of a knee empyema with subsequent metastatic mediastinitis. Clinical, radiological, biochemical and microbiological data are correlated with histopathological findings. The development of this unusual thoracic aortic aneurysm is shown from impending rupture to successful vascular graft implantation.

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Literatur

  1. Akashi Y, Ikehara Y, Yamamoto Y et al. (2000) Purulent pericarditis due to group B streptococcus and mycotic aneurysm of the ascending aorta: a case report. Jpn Circ J 64:83–86

    Article  CAS  PubMed  Google Scholar 

  2. Balestra B (2000) Mycotic aneurysms of the aorta caused by infection with Pasteurella multocida. Clin Infect Dis 31:E1–2

    Article  CAS  PubMed  Google Scholar 

  3. Blain H, Laraki R, Levy-Soussan M et al. (1997) Aneurysm of the thoracic aorta and spondylodiscitis disclosing brucellosis. Rev Med Interne 18:876–881

    Article  CAS  PubMed  Google Scholar 

  4. Brook I, Frazier EH (1999) Aerobic and anaerobic microbiology of mycotic aortic aneurysm. Clin Infect Dis 28:928–929

    Article  CAS  PubMed  Google Scholar 

  5. Buckmaster MJ, Curci JA, Murray PR et al. (1999) Source of elastin-degrading enzymes in mycotic aortic aneurysms: bacteria or host inflammatory response? Cardiovasc Surg 7:1–2

    Article  Google Scholar 

  6. Gomes MN, Choyke PL, Wallace RB (1992) Infected aortic aneurysms. A changing entity. Ann Surg 215:435–442

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Kovoor JME, Jayakumur PN, Srikanth SG et al. (2001) Intracranial infective aneurysms: angiographic evaluation with treatment. Neurol India 49:262–266

    CAS  PubMed  Google Scholar 

  8. Levy DM (1985) Centenary of William Osler's 1885 Gulstonian Lectures and their place in the history of bacterial endocarditis. J R Soc Med 78:1039–1046

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Pruitt RD (1982) William Osler and his Gulstonian Lectures on malignant endocarditis. Mayo Clin Proc 57:4–9

    CAS  PubMed  Google Scholar 

  10. Risher WH, McFadden PM (1994) Neisseria gonorrhoeae mycotic ascending aortic aneurysm. Ann Thorac Surg 57:748–750

    Article  CAS  PubMed  Google Scholar 

  11. Rubery PT, Smith MD, Cammisa FP et al. (1995) Mycotic aortic aneurysm in patients who have lumbar vertebral osteomyelitis. A report of two cases. J Bone Joint Surg Am 77:1729–1732

    Article  CAS  PubMed  Google Scholar 

  12. Segesser LK von, Vogt P, Genoni M et al. (1997) The infected aorta. J Card Surg 12 [Suppl 2]:256–260; discussion 260–261

  13. Shaikholeslami R, Tomlinson CW, Teoh KH et al. (1999) Mycotic aneurysms complicating staphylococcal endocarditis. Can J Cardiol 15:217–222

    CAS  PubMed  Google Scholar 

  14. Shintaku M, Sangawa A, Yonezawa A et al. (2001) Aortic lesions in pulmonary aspergillosis: histopathological study of two autopsy cases. Virchows Arch 439:640–644

    Article  CAS  PubMed  Google Scholar 

  15. Tiesenhausen K, Amann W, Thalhammer M (1999) Die primär bakteriell infizierte Arterie. Chirurg 70:1163–1167

    Article  CAS  PubMed  Google Scholar 

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Danksagung

Für die präoperative computertomographische Aufnahme danken wir Herrn Prof. Dr. V. Nicolas, Direktor des Institutes für Radiologie und Nuklearmedizin an den BG Kliniken Bergmannsheil, Klinikum der Ruhr-Universität Bochum.

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Authors and Affiliations

  1. Institut für Pathologie an der BG Klinik Bergmannsheil-Universitätsklinik, Ruhr-Universität Bochum, Germany

    E. Harrer & K.-M. Müller

  2. Institut für Pathologie an der BG Klinik Bergmannsheil-Universitätsklinik, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany

    E. Harrer

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  1. E. Harrer
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  2. K.-M. Müller
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Correspondence to E. Harrer.

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Harrer, E., Müller, KM. Thorakales Aortenaneurysma bei metastatischer Mediastinitis. Pathologe 24, 146–149 (2003). https://doi.org/10.1007/s00292-002-0597-2

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  • DOI: https://doi.org/10.1007/s00292-002-0597-2

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