A strobe multicenter descriptive study of 55 infectious aortitis

Infectious aortitis (IA) is a rare and severe disease. The treatment classically associates open surgery with prolonged antibiotic therapy. This study aimed to describe clinical characteristics, medical and surgical supports in a large and current series of IA.We conducted a retrospective multicente...

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Bibliographic Details
Published in:Medicine (Baltimore) 2020-10, Vol.99 (40), p.e22422
Main Authors: Journeau, Louis, de la Chapelle, Marine, Guimard, Thomas, Ferfar, Yasmina, Saadoun, David, Mahé, Isabelle, Castier, Yves, Montravers, Philippe, Lescure, Xavier, Van Gysel, Damien, Asseray, Nathalie, Lascarrou, Jean-Baptiste, Ngohou, Chan, Vandamme, Yves-Marie, Connault, Jérôme, Cepoy, Patrick Desbordes de, Brochard, Julia, Goueffic, Yann, Pistorius, Marc-Antoine, Boutoille, David, Espitia, Olivier
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Aged, 80 and over
Aortitis - microbiology
Aortitis - mortality
Aortitis - physiopathology
Aortitis - therapy
Female
Humans
Immunosuppression - adverse effects
Male
Middle Aged
Observational Study
Positron Emission Tomography Computed Tomography
Retrospective Studies
Sex Factors
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Summary:Infectious aortitis (IA) is a rare and severe disease. The treatment classically associates open surgery with prolonged antibiotic therapy. This study aimed to describe clinical characteristics, medical and surgical supports in a large and current series of IA.We conducted a retrospective multicenter study of native aorta IA, between 2000 and 2019. Inclusion criteria were the presence of a microorganism on blood culture, aortic sample or any other validated technique and structural anomaly in imaging.We included 55 patients (85% men), with a median age of 65. Microbiology data substantially differed from previous studies with 12 Gram-negative rods IA, of which only 3 due to Salmonella spp., 24 Gram-positive cocci IA of which 12 Streptococcus spp., and 18 IA due to intracellular growth and/or fastidious microorganisms, of which 8 Coxiella burnetii, 3 Treponema pallidum, and 5 tuberculosis suspicious cases. Fifteen patients (27%) presented with thoracic IA, 31 (56%) with abdominal IA, and 9 (16%) with thoraco-abdominal IA. Eight patients had no surgery, 41 underwent open surgery, only 4 endovascular aneurysm repair, and 2 a combination of these 2 techniques. Nine patients died before 1-month follow-up. There was no difference in the mortality rate between the different types of germ or localization of IA.The variety of germs involved in IA increases. Positron emission tomography-computed tomography scan is a very useful tool for diagnosis. Surgery is still mainly done in open approach and a prospective multicenter study seems necessary to better determine the place of endovascular aneurysm repair versus open surgery.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000022422