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Case Reports in Vascular Medicine
Volume 2017, Article ID 4984325, 3 pages
https://doi.org/10.1155/2017/4984325
Case Report

A Rare Report of Infectious Emphysematous Aortitis Secondary to Clostridium septicum without Prior Vascular Intervention

1Internal Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
2Pulmonary, Sleep and Critical Care Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA

Correspondence should be addressed to Ciel Harris; ude.lfu.xaj@sirrah.leic

Received 12 March 2017; Accepted 13 August 2017; Published 17 September 2017

Academic Editor: Yi-Jen Chen

Copyright © 2017 Ciel Harris et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The term “mycotic aneurysm” was first used by Osler in 1882 to describe a mushroom-shaped aneurysm in subacute bacterial endocarditis. Mycotic aneurysms account for only 2.6% of all aneurysms of the aorta. Rarer still are anaerobic infections secondary to organisms such as Clostridium septicum, which results in emphysematous aortitis. The vast majority of emphysematous aortic infections occur as a result of instrumentation; however, in this case we present an infection de novo. A 75-year-old male presented with a 2-week history of progressive fatigue and chest pain that then developed into constitutional symptoms. Chest radiograph demonstrated an obvious widened mediastinum. CT angiogram of his chest then confirmed this finding as well as significant periaortic gas and focal outpouching. Numerous diverticuli with inflammatory changes consistent with diverticulitis was observed on CT abdomen. Blood cultures returned positive for Clostridium septicum. Definitive treatment was discussed including debridement and graft insertion; however, patient decided on conservative management and was discharged on intravenous antibiotics. Unfortunately, as in most cases of emphysematous aortitis that do not undergo surgical management, the patient succumbed to his illness. The lesson provided will be the epidemiology of emphysematous aortitis, presentation, diagnosis, management, and prognosis through a case report.