RESUMO
Peripheral vascular expressions of Coxiella burnetti Q fever are not well known. Endocarditis with negative blood culture is the most frequent clinical presentation of chronic Q fever. To date, very few cases of aneurisms or vascular grafts infections have been described. We report the case of a 54-year-old man who presented an infrarenal abdominal aorta infection, leading to a giant pseudo aneurismal formation. Blood serology and polymerase chain reaction amplification identified C. burnetti from the aortic thrombus after pseudo aneurism surgery. The treatment associated infrarenal abdominal aorta repair using a cryopreserved aorta allograft, and long-term antibiotic therapy.
Assuntos
Falso Aneurisma/diagnóstico , Doenças da Aorta/microbiologia , Coxiella burnetii , Febre Q/diagnóstico , Anticorpos Antibacterianos/sangue , Aorta Abdominal , Doenças da Aorta/tratamento farmacológico , Doenças da Aorta/cirurgia , Coxiella burnetii/genética , Coxiella burnetii/imunologia , DNA Bacteriano/análise , Humanos , Rim , Masculino , Pessoa de Meia-Idade , Febre Q/tratamento farmacológicoRESUMO
The erosion of the lumbar vertebral bodies by a chronic contained rupture of an infra-renal abdominal aortic aneurysm is a rare event. Chronic contained rupture can cause diagnostic difficulties as there are many clinical presentations, such as: back pain, sciatic pain or an expansive abdominal mass. The diagnosis is sometimes made following an incidental finding on radiological examination. Currently a CT scan is the gold standard diagnostic tool. The outcome following urgent surgical or endovascular repair is equivalent to that of an elective aneurysm repair. We report a case of a 59 year old man admitted for septic rupture of a cutaneous fistula resulting from a false aneurysm in the left groin. Pre-operative CT scan revealed a 6 cm abdominal aortic aneurysm, with chronic contained rupture. This had caused bone erosion of the vertebral body of the third lumbar vertebrae.