• MeSH
• Aorta, Thoracic * diagnostic imaging   pathology   MeSH
• Aortitis * diagnostic imaging   etiology   physiopathology   pathology   MeSH
• Arteritis diagnosis   pathology   therapy   MeSH
• Diagnosis, Differential MeSH
• Humans MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Infekční pseudoaneurysma aorty je rychle progredující onemocnění s vysokou mortalitou, pro něž je zásadní časná diagnostika a kombinovaná terapie. Symptomy jsou kombinací příznaků aortálního syndromu s elevací zánětlivých markerů. Základem terapie je několikatýdenní antibiotická terapie (ideálně cílená dle pozitivity hemokultur) v kombinaci s chirurgickou či endovaskulární terapií dle celkového stavu pacienta. Komplikací je ruptura pseudoaneurysmatu s fatálními následky, která je v závislosti na rychlosti progrese růstu pseudoaneurysmatu značným rizikem.

Infectious pseudoaneurysm of the aorta is a rapidly progressive disease with high mortality. Therefore, early diagnosis and combination therapy are crucial. The condition is manifested by signs of aortic syndrome and elevated inflammatory markers. The treatment consists of antibiotic therapy (based on blood cultures) in combination with surgical or endovascular approach according to the general condition of the patient. The main complication, depending on the rate of progression, is aortic wall rupture with fatal consequences.

• MeSH
• Aortic Aneurysm, Thoracic * diagnostic imaging   etiology   complications   pathology   therapy   MeSH
• Aortitis * diagnostic imaging   etiology   complications   pathology   therapy   MeSH
• Computed Tomography Angiography MeSH
• Fatal Outcome MeSH
• Humans MeSH
• Aneurysm, False diagnostic imaging   etiology   complications   pathology   therapy   MeSH
• Postoperative Complications MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Publication type
• Case Reports MeSH

Infekční aortitida je závažné akutní onemocnění s vysokou mortalitou. Dle současných doporučení spočívá její terapie v antibiotické terapii a radikální chirurgické léčbě, avšak vzhledem k tomu, že toto onemocnění postihuje i interně polymorbidní pacienty ve vysokém věku, není radikální chirurgická léčba často možná. Endovaskulární terapie v kombinaci s protrahovanou antibiotickou terapií tak mnohdy představuje jedinou možnou léčbu a přináší uspokojivé výsledky. Níže prezentujeme případ pacienta léčeného v našem centru a přehled literatury.

Infectious aortitis is a serious acute disease with a high mortality rate. According to current guidelines, its treatment consists of antibiotic therapy and radical surgical treatment, but since this disease also affects patients of advanced age with multiple internal medicine comorbidities, radical surgical treatment is often not possible. Endovascular therapy in combination with prolonged antibiotic therapy is often the only possible treatment and brings satisfactory results. Below we present a case of a patient treated in our centre and a review of the literature.

• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Aortitis * surgery   diagnostic imaging   etiology   drug therapy   mortality   therapy   MeSH
• Blood Vessel Prosthesis MeSH
• Endovascular Procedures * methods   instrumentation   MeSH
• Kaplan-Meier Estimate MeSH
• Coronary Artery Bypass MeSH
• Humans MeSH
• Positron Emission Tomography Computed Tomography MeSH
• Heart Disease Risk Factors MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Acute Aortic Syndrome diagnostic imaging   pathology   therapy   MeSH
• Aortic Aneurysm, Thoracic diagnostic imaging   pathology   therapy   MeSH
• Aortitis etiology   classification   pathology   MeSH
• Chest Pain diagnostic imaging   etiology   pathology   MeSH
• Diagnostic Techniques, Cardiovascular classification   MeSH
• Humans MeSH
• Vascular Diseases * diagnostic imaging   classification   pathology   therapy   MeSH
• Giant Cell Arteritis diagnostic imaging   drug therapy   pathology   MeSH
• Superior Vena Cava Syndrome diagnosis   etiology   pathology   MeSH
• Takayasu Arteritis diagnosis   drug therapy   pathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Úvod: Lymfoplazmocytárna aortitída patrí medzi menej časté príčiny vzniku aneuryzmy hrudnej aorty. Kazuistika: Prezentujeme prípad pacientky so symptomatickou aneuryzmou pri aortitíde ascendentnej aorty a perikarditíde diagnostikovanej na CT vyšetrení ako akútny intramurálny hematóm. Pacientka podstúpila emergentnú suprakoronárnu náhradu ascendentnej aorty cievnou protézou. Perioperačným nálezom bola aneuryzma so zápalovým zhrubnutím aortálnej steny. Histopatologický obraz zodpovedal lymfoplazmocytárnej aortitíde. Záver: Prípad demonštruje, že lymfoplazmocytárna aortitída môže symptomatológiou a rádiologickým obrazom viesť k mylnej diagnóze intramurálneho hematómu.

Introduction: Lymphoplasmacytic thoracic aortitis is still underrecognized cause of thoracic aortic aneurysm. Case report: We herein report a case of symptomatic inflammatory ascending aortic aneurysm and pericarditis diagnosed on CT scan as acute type A intramural hematoma. Patient underwent emergency supracoronary ascending aorta replacement with a prosthetic graft. Marked inflammatory thickening of aneurysm wall was the intraoperative finding. Histopathologic examination of the excised aortic tissue showed inflammation with lymphoplasmacytic pattern of aortitis. Conclusion: This case demonstrates that lymphoplasmacytic aortitis may mimic symptoms and radiological findings of intramural hematoma.

• MeSH
• Aortic Aneurysm, Thoracic * surgery   diagnostic imaging   MeSH
• Aorta, Thoracic surgery   pathology   MeSH
• Aortitis * diagnosis   drug therapy   immunology   MeSH
• Diagnosis, Differential MeSH
• Hematoma diagnostic imaging   MeSH
• Immunoglobulin G4-Related Disease MeSH
• Middle Aged MeSH
• Humans MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

V kazuistice popisujeme případ 71leté ženy přijaté cestou geriatrické ambulance k došetření přetrvávající námahové dušnosti, nespecifických bolestí na hrudi s propagací do ramenou a intermitentních febrilií. Pacientka byla rozsáhle vyšetřována, bylo provedeno kardiologické, pneumologické, revmatologické vyšetření, laboratorní a zobrazovací metody vč. PET/CT, které prokázalo příčinu potíží. Pacientka je od té doby v péči revmatologa. V současné době po 3 měsících léčby po přechodném omezení fyzické námahy opět zvládá své četné fyzické aktivity.

In this case report, we describe the case of a 71-year-old woman admitted via the geriatric outpatient department in order to investigate persistent exertional dyspnoea, non-specific chest pain with propagation to the shoulders and intermittent fever. The patient was examined extensively, during which cardiology, pneumology, rheumatology, laboratory and imaging tests were performed incl. PET/CT, which showed the cause of the problem. The patient was reffered to a rheumatologist for the guidance of the therapy. Currently, after 3 months of treatment with temporary limitation of physical effort, she is able to manage her numerous physical activities without major difficulties again.

• MeSH
• Aortitis * diagnosis   complications   therapy   MeSH
• Diagnostic Techniques and Procedures MeSH
• Dyspnea etiology   MeSH
• Fever of Unknown Origin etiology   MeSH
• Humans MeSH
• Positron Emission Tomography Computed Tomography methods   MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Aortitis * diagnosis   epidemiology   drug therapy   MeSH
• Antibodies, Monoclonal, Humanized therapeutic use   MeSH
• Immunoglobulin G4-Related Disease epidemiology   MeSH
• Immunosuppressive Agents therapeutic use   MeSH
• Janus Kinases metabolism   MeSH
• Leflunomide therapeutic use   MeSH
• Humans MeSH
• Giant Cell Arteritis diagnosis   epidemiology   MeSH
• Positron Emission Tomography Computed Tomography methods   MeSH
• Takayasu Arteritis diagnosis   epidemiology   drug therapy   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Review MeSH

Takayasu disease belongs to the group of autoimmune vasculitis which most often affects the aorta and its branches. It is rare, and it mainly affects young women. Recent epidemiologic studies suggest that Takayasu arteritis is being increasingly recognized in Europe. The first symptoms are non-specific and an early diagnosis is difficult and requires clinical awareness and suspicion. Patients with Takayasu arteritis often present increased inflammatory markers, including C-reactive protein and erythrocyte sedimentation rate, but systemic inflammatory response does not always show a positive correlation with inflammatory activity in the vessel wall. Therefore, imaging studies play a principal role in diagnosis and control of the disease. Glucocorticoids remain the most effective and serve as a cornerstone first line treatment. Immunosuppressive drugs play an important role as well, and biological therapy is increasingly being included in the treatment. This article describes the epidemiology, pathophysiology, diagnostics and treatment of this rare disease, so as to alert clinicians because disease left untreated can lead to narrowing and even closure of vital blood vessels. The most common Takayasu arteritis complications include pulmonary thrombosis, aortic regurgitation, congestive heart failure, cerebrovascular events, vision degeneration or blindness, and hearing problems.

• MeSH
• Aortitis epidemiology   pathology   MeSH
• Azathioprine administration & dosage   pharmacology   MeSH
• Biological Therapy MeSH
• Biomarkers blood   MeSH
• Endothelium, Vascular immunology   pathology   MeSH
• Cyclophosphamide administration & dosage   pharmacology   MeSH
• Diagnosis, Differential MeSH
• Endovascular Procedures MeSH
• Glucocorticoids administration & dosage   pharmacology   MeSH
• Antibodies, Monoclonal, Humanized pharmacology   therapeutic use   MeSH
• Immunosuppressive Agents administration & dosage   pharmacology   MeSH
• Humans MeSH
• Methotrexate administration & dosage   pharmacology   MeSH
• Neovascularization, Pathologic epidemiology   etiology   pathology   MeSH
• Receptors, Interleukin-6 antagonists & inhibitors   MeSH
• Takayasu Arteritis * diagnosis   epidemiology   immunology   therapy   MeSH
• Tumor Necrosis Factor-alpha pharmacology   therapeutic use   MeSH
• Tunica Intima immunology   pathology   MeSH
• Ustekinumab pharmacology   therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Aortitida může vyvolat horečku neznámého původu. Vyšetření pacientů prokazuje přítomnost sepse. Pokud jsme nedokázali určit její příčinu, zvažovali jsme použití transthorakální echokardiografi e, která však obtížně prokazuje postižení sestupné aorty. Proto je vhodné u pacientů s aortitidou mít na paměti možnost diagnostiky pomocí CT angiografi e. Popisujeme případ pacienta, který byl dopraven do naší nemocnice se sepsí. Vyšetření odhalilo přítomnost sakulárního aneurysmatu, periaortálního abscesu a nahromadění vzduchu v oblasti hrudní aorty v důsledku infekce gram-pozitivní bakterií Staphylococcus aureus.

Aortitis can cause fever of unknown origin. Those affected patients had presented with sepsis. It is an important consideration that when we could not identify the origin of transthoracic echocardiography. However, it is diffi cult to be revealed of descending aorta by transthoracic echocardiography. Therefore computed tomography angiography may be kept in mind for diagnosis in patients with aortitis. We report a patient presenting to our hospital with sepsis and detected a sa

• MeSH
• Aortic Aneurysm diagnosis   etiology   MeSH
• Aortitis * diagnosis   drug therapy   complications   MeSH
• Computed Tomography Angiography methods   MeSH
• Echocardiography methods   MeSH
• Fever of Unknown Origin * etiology   MeSH
• Clinical Laboratory Techniques MeSH
• Humans MeSH
• Aged MeSH
• Sepsis MeSH
• Death MeSH
• Staphylococcal Infections * MeSH
• Staphylococcus aureus MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Aortitis * diagnosis   microbiology   therapy   MeSH
• Diagnostic Imaging methods   MeSH
• Diagnosis, Differential MeSH
• Cardiovascular Infections diagnosis   microbiology   therapy   MeSH
• Clinical Laboratory Techniques methods   MeSH
• Humans MeSH
• Syphilis, Cardiovascular MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH